title: HIV drug resistance and its impact on antiretroviral therapy in Chinese HIV-infected patients.
abstract: BACKGROUND
  Highly active antiretroviral therapy (HAART) has significantly decreased mortality among Chinese HIV patients. However, emerging HIV drug resistance (HIVDR) poses a growing threat to the long-term success and durability of HAART.
  
  
  METHODS
  Three cross-sectional surveys were conducted across the country from 2004 to 2006, respectively. Patients completed a questionnaire and provided blood for CD4 cell count, HIV viral load (VL), and HIV resistance genotyping. Factors associated with HIVDR were identified by logistic regression.
  
  
  RESULTS
  3667 unique patients were included across the three surveys. Among 2826 treatment-experienced patients, median duration of treatment was 17.4 (IQR 8.6-28.4) months and HIVDR was identified in 543 (19.2%). Factors significantly associated with HIVDR included ART drug distribution location, CD4 cell count, initial HAART regimen, self-reported medication adherence, and province.
  
  
  CONCLUSIONS
  Virologic failure increased over time on therapy but a significant proportion of patients in failure had no resistance mutations identified, suggesting that treatment adherence is suboptimal and must be emphasized. Due to the significantly higher risk of HIVDR in certain provinces, additional steps to reduce HIVDR should be taken.
authors: State Key Laboratory for Infectious Disease Prevention and Control, and National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
authors: Hui
authors: H
authors: Xing
authors: Yuhua
authors: Y
authors: Ruan
authors: Jingyun
authors: J
authors: Li
authors: Hong
authors: H
authors: Shang
authors: Ping
authors: P
authors: Zhong
authors: Xia
authors: X
authors: Wang
authors: Lingjie
authors: L
authors: Liao
authors: Hanping
authors: H
authors: Li
authors: Min
authors: M
authors: Zhang
authors: Yile
authors: Y
authors: Xue
authors: Zhe
authors: Z
authors: Wang
authors: Bin
authors: B
authors: Su
authors: Wei
authors: W
authors: Liu
authors: Yonghui
authors: Y
authors: Dong
authors: Yanling
authors: Y
authors: Ma
authors: Huiqin
authors: H
authors: Li
authors: Guangming
authors: G
authors: Qin
authors: Lin
authors: L
authors: Chen
authors: Xiaohong
authors: X
authors: Pan
authors: Xi
authors: X
authors: Chen
authors: Guoping
authors: G
authors: Peng
authors: Jihua
authors: J
authors: Fu
authors: Ray Y
authors: RY
authors: Chen
authors: Laiyi
authors: L
authors: Kang
authors: Yiming
authors: Y
authors: Shao
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D023241:Antiretroviral Therapy, Highly Active / Q000379:methods*; D044466:Asian People; D018791:CD4 Lymphocyte Count; D003430:Cross-Sectional Studies; D024882:Drug Resistance, Viral; D005260:Female; D005838:Genotype; D015658:HIV Infections / Q000188:drug therapy* / Q000235:genetics / Q000276:immunology / Q000821:virology; D015497:HIV-1 / Q000187:drug effects / Q000235:genetics; D006801:Humans; D008297:Male; D008875:Middle Aged; D009154:Mutation / Q000187:drug effects; D012307:Risk Factors; D019562:Viral Load / Q000187:drug effects
chemical_list: D019380:Anti-HIV Agents
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