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Article: Prevalence of drug-resistant HIV-1 in rural areas of hubei province in the people's republic of China

TitlePrevalence of drug-resistant HIV-1 in rural areas of hubei province in the people's republic of China
Authors
KeywordsChina
Drug resistance
HAART
HIV-1
Subtype B'
Issue Date2009
PublisherLippincott Williams & Wilkins. The Journal's web site is located at http://www.jaids.com
Citation
Journal Of Acquired Immune Deficiency Syndromes, 2009, v. 50 n. 1, p. 1-8 How to Cite?
AbstractOBJECTIVE: To determine the prevalence of drug-resistant HIV-1 and the efficacy of first-line highly active antiretroviral therapy (HAART) regimens consisted of generic nucleoside reverse transcriptase inhibitor and nonnucleoside reverse transcriptase inhibitor among 339 study subjects in rural areas of Hubei province, China. METHODS: Two cross-sectional studies were conducted to investigate 150 HAART-naive (99 received subsequent therapy) between 2003 and 2005 and 288 HAART-experienced patients mainly between 2005 and 2006. Patients' CD4 T-cell count and viral load were determined. HIV-1 pol gene fragments were amplified from patients' plasma by reverse transcriptase- polymerase chain reaction, subsequently sequenced and analyzed. RESULTS: About 83.5% of the patients were from rural villages. They were dominantly infected with subtype B HIV-1 (96.7%) through paid blood donation (64.6%) and related blood transfusion (28.3%). We found that there was a steady increase of CD4 count over time among treated patients without detectable viral load (186/288, 64.6%). There was, however, an increasing prevalence of nucleoside reverse transcriptase inhibitor- and nonnucleoside reverse transcriptase inhibitor-resistant mutations among patients with detected viremia (102/288, 35.4%) after treatment for 3-6 (24.3%), 9-12 (57.1%), and 20-24 (63.3%) months, respectively. The increasing rates were associated with significant CD4 count drop and viral load increase. Some patients also developed multidrug-resistant mutants. CONCLUSIONS: We report the first HIV-1 drug resistance study after 2 years on HAART among Chinese patients living in rural villages. Our data suggest that a significant portion of patients are failing first-line regimens with a trend of AIDS progression. It is therefore necessary to maximize the drug adherence and to make affordable second-line HAART regimens available immediately. Our results have implications for implementing HAART in underresourced developing country settings. Copyright © 2008 by Lippincott Williams & Wilkins.
Persistent Identifierhttp://hdl.handle.net/10722/60140
ISSN
2015 Impact Factor: 3.806
2015 SCImago Journal Rankings: 2.434
References

 

DC FieldValueLanguage
dc.contributor.authorLuo, Men_HK
dc.contributor.authorLiu, Hen_HK
dc.contributor.authorZhuang, Ken_HK
dc.contributor.authorLiu, Len_HK
dc.contributor.authorSu, Ben_HK
dc.contributor.authorYang, Ren_HK
dc.contributor.authorTien, Pen_HK
dc.contributor.authorZhang, Len_HK
dc.contributor.authorGui, Xen_HK
dc.contributor.authorChen, Zen_HK
dc.date.accessioned2010-05-31T04:04:33Z-
dc.date.available2010-05-31T04:04:33Z-
dc.date.issued2009en_HK
dc.identifier.citationJournal Of Acquired Immune Deficiency Syndromes, 2009, v. 50 n. 1, p. 1-8en_HK
dc.identifier.issn1525-4135en_HK
dc.identifier.urihttp://hdl.handle.net/10722/60140-
dc.description.abstractOBJECTIVE: To determine the prevalence of drug-resistant HIV-1 and the efficacy of first-line highly active antiretroviral therapy (HAART) regimens consisted of generic nucleoside reverse transcriptase inhibitor and nonnucleoside reverse transcriptase inhibitor among 339 study subjects in rural areas of Hubei province, China. METHODS: Two cross-sectional studies were conducted to investigate 150 HAART-naive (99 received subsequent therapy) between 2003 and 2005 and 288 HAART-experienced patients mainly between 2005 and 2006. Patients' CD4 T-cell count and viral load were determined. HIV-1 pol gene fragments were amplified from patients' plasma by reverse transcriptase- polymerase chain reaction, subsequently sequenced and analyzed. RESULTS: About 83.5% of the patients were from rural villages. They were dominantly infected with subtype B HIV-1 (96.7%) through paid blood donation (64.6%) and related blood transfusion (28.3%). We found that there was a steady increase of CD4 count over time among treated patients without detectable viral load (186/288, 64.6%). There was, however, an increasing prevalence of nucleoside reverse transcriptase inhibitor- and nonnucleoside reverse transcriptase inhibitor-resistant mutations among patients with detected viremia (102/288, 35.4%) after treatment for 3-6 (24.3%), 9-12 (57.1%), and 20-24 (63.3%) months, respectively. The increasing rates were associated with significant CD4 count drop and viral load increase. Some patients also developed multidrug-resistant mutants. CONCLUSIONS: We report the first HIV-1 drug resistance study after 2 years on HAART among Chinese patients living in rural villages. Our data suggest that a significant portion of patients are failing first-line regimens with a trend of AIDS progression. It is therefore necessary to maximize the drug adherence and to make affordable second-line HAART regimens available immediately. Our results have implications for implementing HAART in underresourced developing country settings. Copyright © 2008 by Lippincott Williams & Wilkins.en_HK
dc.languageengen_HK
dc.publisherLippincott Williams & Wilkins. The Journal's web site is located at http://www.jaids.comen_HK
dc.relation.ispartofJournal of Acquired Immune Deficiency Syndromesen_HK
dc.rightsJournal of Acquired Immune Deficiency Syndromes. Copyright © Lippincott Williams & Wilkins.en_HK
dc.subjectChinaen_HK
dc.subjectDrug resistanceen_HK
dc.subjectHAARTen_HK
dc.subjectHIV-1en_HK
dc.subjectSubtype B'en_HK
dc.titlePrevalence of drug-resistant HIV-1 in rural areas of hubei province in the people's republic of Chinaen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0894-9255&volume=50 &issue=1&spage=1&epage=8&date=2009&atitle=Prevalence+of+drug-resistant+HIV-1+in+rural+areas+of+Hubei+province+in+the+People%27s+Republic+of+China.en_HK
dc.identifier.emailLiu, L: liuli71@hkucc.hku.hken_HK
dc.identifier.emailChen, Z: zchenai@hku.hken_HK
dc.identifier.authorityLiu, L=rp00268en_HK
dc.identifier.authorityChen, Z=rp00243en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1097/QAI.0b013e31818ffcdcen_HK
dc.identifier.pmid19295329-
dc.identifier.scopuseid_2-s2.0-64249169891en_HK
dc.identifier.hkuros163887en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-64249169891&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume50en_HK
dc.identifier.issue1en_HK
dc.identifier.spage1en_HK
dc.identifier.epage8en_HK
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridLuo, M=26636531600en_HK
dc.identifier.scopusauthoridLiu, H=15019354200en_HK
dc.identifier.scopusauthoridZhuang, K=6603626241en_HK
dc.identifier.scopusauthoridLiu, L=35784425200en_HK
dc.identifier.scopusauthoridSu, B=55041064400en_HK
dc.identifier.scopusauthoridYang, R=23037764400en_HK
dc.identifier.scopusauthoridTien, P=7006421622en_HK
dc.identifier.scopusauthoridZhang, L=8783285300en_HK
dc.identifier.scopusauthoridGui, X=7006336209en_HK
dc.identifier.scopusauthoridChen, Z=35271180800en_HK

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