Influencing factors of treatment failure in AIDS patients receiving first-line highly active antiretroviral therapy

YUAN Yuan; LIU Hongwei; LIU Chunhua; WANG Zhe; RUAN Yuhua; XING Hui

doi:10.3969/j.issn.1002-266X.2016.15.007

Abstract：Objective To understand the treatment failure of AIDS patients treated with first-line highly active antiret-roviral therapy ( HAART) and to analyze the associated factors. Methods AIDS patients treated with first-line HAART after 6 months in the central Henan region were investigated by cross-sectional survey, and their blood samples were collect-ed. Human immunodeficiency virus ( HIV)-1 viral loads were measured by uiral load of full-automatlc real-time fluorescent quantitation, the genotypic drug resistance was determined by amplification/sequencing method, and T lymphocyte count was detected by flow cytometry. Multivariate Logistic regression was used to analyze the factors associated with the develop-ment of virological failure, HIV-1 drug resistance and immunologic failure. Results Among the 740 participants, virologi-cal failure (defined as >1 000 copies/mL) was observed in 304 patients (41. 1%), HIV-1 genotypic drug resistance was found in 243 patents (34. 4%), and 177 patients (23. 9%) were the current CD4 + lymphocyte<200 cell/μL. Multivari-ate Logistic regression analysis showed that the risk factors associated with the development of drug resistance and virologi-cal failure contained poor compliance, >36 months of treatment and initial regimen with ddI;and the risk factors associat-ed with immunologic failure contained male, poor compliance and initial regimen with ddI. Conclusions The main rea-sons for treatment failure of AIDS patients were virological failure, development of drug resistance and immunologic failure. Patients with poor compliance and initial first-line HAART regimen with ddI were the risk factors associated with treatment failure.