title: [Drug resistance and influencing factors in adult AIDS patients receiving antiretroviral treatment in Dehong, Yunnan province].
abstract: OBJECTIVE
  To investigate the incidence of drug resistance in adult AIDS patients receiving antiretroviral treatment(ART)and influencing factors in Dehong prefecture, Yunnan province during 2012-2014.
  
  
  METHODS
  For this cohort study, all the AIDS patients aged over 15 and receiving ART in Dehong were screened for HIV drug resistance in 2012, and 3 715 patients who had received ART for more than 6 months were enrolled for 12 months and 24 months follow up.
  
  
  RESULTS
  Among the 3 715 patients, 56.6% were males, 72.6% were aged 26-45 years and 76.0% were married. The main treatment regimen was nevirapine(NVP)+ lamivudine(3TC)+ zidovudine(AZT)(38.2%). A total of 3 556 patients(95.7%)received at least one viral load testing during the two years follow-up, among them 253(7.1%)patients had VL≥1 000 copies/ml, in which 211(83.4%)received drug resistance related gene mutation testing, the results indicated that the drug resistance developed in 52 and 39 patients in 2013 and 2014(1.43 per 100 person years and 0.88 per 100 person years)respectively. The overall HIV drug incidence was 1.13 per 100 person years. Multivariate regression analysis indicated that age ≤25 years, to be infected through drug use, treatment regimen as D4T+ 3TC +NVP and baseline CD4(+) T cells ≤200 cells/μl were the risk factor of HIV drug resistance. Eleven HIV gene subtypes were detected in the 82 patients with newly developed drug resistance, CRF_BC was predominant(31.7%), followed by CRF01_AE(22.0%)and C(19.5%). Ten patients were infected with mixed subtypes of CRF_BC/B', CRF_BC/CRF_01B and CRF_BC/C. Most of the 82 patients were resistant to NRTIs and NNRTIs, the main mutation loci were M184V and K103N.
  
  
  CONCLUSIONS
  The incidence of drug resistance in adult AIDS patients receiving ART was relatively low in Dehong. However, it is necessary to conduct the health education in young people and drug users to improve the treatment compliance and strengthen the surveillance for HIV drug resistance.
authors.affiliation: Dehong Prefecture Center for Disease Control and Prevention, Mangshi 678400, China.
authors.forename: S T
authors.initials: ST
authors.lastname: Yao
authors.affiliation: Department of Epidemiology and Key Laboratory of Public Health Safety of Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Yao
authors.affiliation: Ruili City People's Hospital, Ruili 678600, China.
authors.forename: Y
authors.initials: Y
authors.lastname: Shi
authors.affiliation: Mangshi City People's Hospital, Mangshi 678400, China.
authors.forename: P Y
authors.initials: PY
authors.lastname: Li
authors.affiliation: Longchuan County People's Hospital, Longchuan 678700, China.
authors.forename: Y W
authors.initials: YW
authors.lastname: Xu
authors.affiliation: Yingjiang County People's Hospital, Yingjiang 679300, China.
authors.forename: W Q
authors.initials: WQ
authors.lastname: Yang
authors.affiliation: Dehong Prefecture People's Hospital, Mangshi 678400, China.
authors.forename: Y D
authors.initials: YD
authors.lastname: Zhang
authors.affiliation: Lianghe County People's Hospital, Lianghe 679200, China.
authors.forename: C Y
authors.initials: CY
authors.lastname: Yin
authors.affiliation: Yingjiang County Hospital of Traditional Chinese Medicine, Yingjiang 678300, China.
authors.forename: L Q
authors.initials: LQ
authors.lastname: Cun
authors.affiliation: Wanding Hospital, Wanding 678500, China.
authors.forename: Z J
authors.initials: ZJ
authors.lastname: Zhai
authors.affiliation: Department of Epidemiology and Key Laboratory of Public Health Safety of Ministry of Education, School of Public Health, Fudan University, Shanghai 200032, China.
authors.forename: N
authors.initials: N
authors.lastname: He
authors.affiliation: Dehong Prefecture Center for Disease Control and Prevention, Mangshi 678400, China.
authors.forename: S
authors.initials: S
authors.lastname: Duan
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000627:therapeutic use*; D002681:China / Q000453:epidemiology; D015331:Cohort Studies; D004351:Drug Resistance / Q000235:genetics*; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D019259:Lamivudine / Q000627:therapeutic use; D008297:Male; D009154:Mutation; D010349:Patient Compliance; D018894:Reverse Transcriptase Inhibitors / Q000627:therapeutic use*; D012307:Risk Factors; D019562:Viral Load
chemical_list: D019380:Anti-HIV Agents; D018894:Reverse Transcriptase Inhibitors; D019259:Lamivudine