ABSTRACT
Objective To understand the current situation related to genotypic resistance in patients receiving the first-line antiretroviral treatment,but with with virologic failure,in Henan province and to compare the patterns of drug resistance in patients from different areas.Methods 276 patients with virologic failure on first-line antiretroviral treatment were selected in three different areas of Henan,in 2010.CD4 +T cells,virus load and genotypic resistance were measured and tested.Prevalence and mutations related to drug-resistant were analyzed.Results The overall prevalence of drug-resistance was 68.48％ in 257 patients,with non-nucleoside reverse transcriptase inhibitor (NNRTIs) as 67.70％.Rate of nucleoside reverse transcriptase inhibitor (NRTIs) was 54.09％,and protease inhibitors (PIs) was 1.18％.The prevalence rates of drug-resistance in A,B and C groups were 82.35％,97.47％ and 52.80％,respectively,and withs significant differences (x2=50.624,P=0.000).The Prevalence rates related to resistance of NNRTIs and NRTIs were also significantly different ( x2＝48.771,P=0.000 and x2=33.912,P=0.000).26.46％ of the samples had M184V/I mutation which was the highest NRTIs mutation among the 257 patients.The prevalence rates on resistance of A and B were 47.06％ and 49.37％,higher than that of C( 13.04％,x2=39.905,P=0.000)followed by TAMs,TAMs-1 and TAMs-2 which were 8.56％ and 4.28％.C had the lower prevalence of TAMs-1 thanA and B (x2=13.499,P=0.001).40.47％ of the samples harbored ≥1 TAM,with T215Y/F having the most,as 33.85％.31.13％ of 257 patients appeared most NNRTIs mutation K103N in this study,with the prevalence rates also significant different (x2=14.213,P=0.001 ) in the three areas.Two PIs mutations were detected in 257 patients:M461/L,(1.17％) and V82F (0.39％).However,none was detected in area A.Conclusion Different patterns of drug resistance were found in different areas of Henan province and should be treated differently.The work related to AIDS second-line antiretroviral therapy in Henan should be more opportune,rigorous and standardized.
ABSTRACT
Objective To elucidate the prevalence and the mutation pattern of N348I that related to the resistance seen in the AIDS patients, in China. Methods Partial pol gene of HIV-1 comprising of full protease (PR) and reverse transeriptase (RT) was obtained from plasma samples of therapy-failure individuals (n=614) and therapy-naive individuals (n=619) by using reverse transcription polymerase chain reaction(RT-PCR). 1233 sequences were then submitted to the HIV-1 drug resistance database of the Stanford University to analyze the prevalence and the emergence pattern of N348I. Results The prevalence of N348I was 6.5％ in the therapy-failure patients and 0.8％ in the naive individuals, respectively. The prevalence of N348I was more popular among those patients whose ART regimens containing zidovudine (AZT or ZDV) than those without AZT in regimens( 14.1％ vs. 4.7％, x2=10.21, P＜0.01 ). N3481 always emerged, and combined with others mutations among patients of ART, whose frequencies were: 85.0％ in combination with thymidine analog mutations (TAMs) and 52.5％ with M184V/I, respectively. Conclusion N348I was somehow prevalent in the therapy-failure patients when using the first-line antiretroviral drugs,and it emerged as unique patterns. This study laid the ground in improving the techaology of drug resistance genotypes detection and providing theoretical basis to study the mechanism of resistance and the law of molecular evolution.
ABSTRACT
Objective To analyze the CD4 +T cells and virus load in HIV/AIDS affected population and to evaluate the HIV/AIDS antiretroviral therapy programs in Henan province.Methods "Henan HIV/AIDS Testing Laboratory Network Database" was used to collect the data on CD4+ T cells and virus load (VL) value and corresponding information in HIV/AIDS population of Henan in 2009. Cross-sectional studies was used to study the constituent ratio of CD4 + T cells and virus load value in individuals who had not received antiretroviral-treated (ART) and had joined first-line ART between the year of 2005 to 2008 among HIV/AIDS population of Henan. Results As to these people living with HIV/AIDS that had not received ART in the first half and the second half year of 2009, the constituent ratio of individuals whose CD4+T cells were less than 200 cells/μl both accounted for more than 20% (χ2=2.059, P=0.151). The constituent ratio of individuals whose CD4+T cells were in 200-350 cells/μl and more than 350 cells/μl increased from 27.61% to 29.41%(χ2=4.636, P=0.031 ) and decreased from 51.49% to 48.60% (χ2=9.767, P=0.002), respectively.Meanwhile, we saw 34.53% and 19.65% of the patients whose virus load was ＞10 000 copy/mland ＞30 000 copy/ml in this population. Patients that joined first-line ART during 2005-2008 showed the following results: the longer of the therapy time, the higher constituent ratio of individuals whose CD4+ T cells were more than 350 cells/μl (χ2= 148.689, P＜0.001) and the lower constituent ratio of individuals of whose CD4+T cells were less than 200 cells/μl (χ2=46.686,P＜0.001).Simultaneously, the lower constituent ratio of individuals whose viral load was less than 500 copy/ml (χ2=9.066, P=0.003) and the higher constituent ratio of individuals whose virus load was more than 10 000 copy/ml (χ2=6.597, P=0.010). Conclusion Significant curative effect had been achieved in AIDS first-line ART of Henan, but along with the increasing treatment time, the risk of treatment failure also increased. Drug resistance test and changing of treatment protocols were needed. To reach better and more efficient effects on therapy, factors as more detections and investments on ART, expanding the scope of treatment etc. were needed on those people living with HIV/AIDS that had not received ART.
ABSTRACT
Objective To study the correlation between genotype drug resistance and CD4+ T-lymphocyte of AIDS patients who received antiretroviral treatment in Henan province. Methods Several indicators were studied through questionnaires and whole blood was collected to analyze CD4+ T-lymphocyte as well as the virus load. In-House technique was used to detect the genotype drug resistance. Results 32.21% and 29.17% of the patients were identified as genotype drug resistant to AIDS when used first and second generation medicine schemes but the improvement (P=0.7538) of disease process was not influenced much. However, if the genotype drug resistance of patients with HAART last longer than two years (33.20%) or patients with HAART less than one year (18.97%), a greater impact on the improvement was noticed. Age (OR=0.68) and the interval on distribution of medicines (OR=1.93) had a great impact on the improvement with the genotype drug resistance through logistic regression analysis. Medicine scheme (OR=0.51), genotype drug resistance (OR=3.20) and the rate of regular dose in a month (OR=0.51) all had a great impact on the improvement to CD4+ T-lymphocyte by logistic regression analysis. Conclusion Part of HIV/AIDS patients showed resistant to genotype drugs in Henan province, suggesting that we must reinforce the surveillance on HAART and program on drug administration to the patients, in order to increase the number of CD4+ T-lymphocyte so as to avoid the development of drug resistance.
ABSTRACT
<p><b>OBJECTIVE</b>To evaluate the therapeutic effect of QuDu ZengNing Capsule on AIDS.</p><p><b>METHODS</b>QuDu ZengNing Capsule is a capsule containing extract from 4 Chinese medicinal herbs. Totally 1,000 AIDS patients were treated, among them 60 patients were clinically observed weekly. Blood routine tests, liver, heart and kidney function, X-ray, CD4, CD8 cells were examined before and after treatment at 1, 3, 6 month. The patients were treated with 4 capsules t.i.d for 6 months.</p><p><b>RESULTS</b>The symptoms were improved in most of the patients, the CD4 cells increased from 115.0 to 295.2/ul and the viral load (RNA copies/ml) in most patients reduced markedly or maintained at the same level.</p><p><b>CONCLUSION</b>These data indicated that QuDu ZengNing Capsule was effective for treatment of AIDS patients.</p>