title: [The efficacy of antiviral therapy and drug resistance analysis among HIV/AIDS patients with heroin addiction in Guangxi Zhuang Autonomous Region].
abstract: OBJECTIVE
  To investigate the impact of heroin for antiviral treatment, drug resistance, mutation types and frequency in HIV/AIDS patients in Guangxi Zhuang Autonomous Region.
  
  
  METHODS
  HIV/AIDS patients were recruited in Methadone Maintenance Treatment Clinics, HIV/AIDS Clinic and HIV Voluntary Counseling and Testing Center Liuzhou and Baise city from April 2008 to October 2009. The patients were grouped by the situation of antiviral treatment and use of heroin. A total of 435 HIV/AIDS patients were recruited, among which 108 cases in antiviral treatment and heroin group, 93 cases in antiviral treatment and never using drug group, 105 cases in no antiviral treatment and using heroin group, 129 cases in no antiviral treatment and never using drug group. The effect of antiviral treatment was evaluated by questionnaire survey, viral load measurement and CD4(+) T lymphocyte count. HIV-1 RNA from plasma was extracted, and then the pol genes were amplified and sequenced. The sequences were analyzed for HIV-1 genotype drug-resistance.
  
  
  RESULTS
  For the patients who received antiviral treatment, the viral load in heroin group was higher than that in never using drug group (lg (2.61 ± 1.24) vs lg (2.08 ± 0.80), t = 3.54, P < 0.05) , and the percentage of viral load lower than 1 000 copies/ml in heroin group was significantly less than that in never using drug group (63.9% vs 86.0%,χ(2) = 12.76, P < 0.05). For the patients who received antiviral treatment, the difference has no significance in CD4(+) T lymphocyte count between heroin group and never using drug group ((337.92 ± 181.66) vs (326.14 ± 254.98), t = 0.38, P = 0.703). For the patients who didn't receive antiviral treatment, the difference also has no significance in CD4(+) T lymphocyte count between heroin group and never using drug group ((373.73 ± 155.97) vs (337.53 ± 209.26), t = 1.47, P = 0.143). For the patients who received antiviral treatment, there was no difference in the percentage of the CD4(+) T lymphocyte count more than 350/ml between heroin group and never using drug group (48.1% vs 43.0%, χ(2) = 0.53, P = 0.466). 319 HIV-1 pol gene sequences were obtained. Among the patients who received antiviral treatment, the mutation frequency of M184V/I, T215Y/F, L210W and T69N/S in heroin abuser group were significantly higher than that in never using drug group (14.9% (11/74) vs 4.4% (3/68), 12.2% (9/74) vs 1.5% (1/68), 12.2% (9/74) vs 1.5% (1/68) and 10.8% (8/74) vs 1.5% (1/68) respectively) (P < 0.05).
  
  
  CONCLUSIONS
  Using heroin may promote HIV replication, reducing the virological response to antiviral treatment and increasing the frequencies of drug resistance loci among HIV/AIDS patients.Heroin rehabilitation may benefit from the antiviral treatment and obtain better antiviral effect.
authors.affiliation: Guangxi Key Laboratory of AIDS Prevention and Treatment; School of Public Health, Guangxi Medical University, Nanning 530021, China.
authors.forename: Bingyu
authors.initials: B
authors.lastname: Liang
authors.forename: Xiaoyi
authors.initials: X
authors.lastname: Yang
authors.forename: Junjun
authors.initials: J
authors.lastname: Jiang
authors.forename: Bo
authors.initials: B
authors.lastname: Zhou
authors.forename: Hui
authors.initials: H
authors.lastname: Chen
authors.forename: Rongfeng
authors.initials: R
authors.lastname: Chen
authors.forename: Fangning
authors.initials: F
authors.lastname: Zhao
authors.forename: Peijiang
authors.initials: P
authors.lastname: Pan
authors.forename: Jiegang
authors.initials: J
authors.lastname: Huang
authors.forename: Li
authors.initials: L
authors.lastname: Ye
authors.affiliation: Email: haolphd@163.com.
authors.forename: Hao
authors.initials: H
authors.lastname: Liang
mesh_terms: D000163:Acquired Immunodeficiency Syndrome; D019380:Anti-HIV Agents; D000998:Antiviral Agents; D018791:CD4 Lymphocyte Count; D002681:China; D004351:Drug Resistance; D024882:Drug Resistance, Viral; D015751:Genes, pol; D015658:HIV Infections; D015497:HIV-1; D003932:Heroin / Q000009:adverse effects*; D006556:Heroin Dependence; D006801:Humans; D009154:Mutation / Q000187:drug effects*; D059645:Mutation Rate; D019562:Viral Load
chemical_list: D019380:Anti-HIV Agents; D000998:Antiviral Agents; D003932:Heroin