| ObjectivePrevious studies have found that drug addicts who were infected with HIV-1 have poor effect of antiviral drug treatment.However,whether drug use has an impact on HIV-related drug-resistance remains to be clarified.The purpose of this study was to assess the impact of drug use on HIV/AIDS patients during antiretroviral therapy(ART)in Liuzhou,Guangxi.Methods(1)Retrospective datas were collected from the national free AIDS prevention and treatment information system for HIV/AIDS patients undergoing ART in Liuzhou,Guangxi,from 2004 to 2017,consist of two database,"basic conditions for adults" and "adult follow-up and drug use conditions".The two databases were linked and reconstructed as a retrospective cohort.(2)The participants were assigned into two groups,exposure group(drug use group)and non-exposure group(non-drug use group),according to whether they used drugs or not.(3)Chi-square test or Fisher’s exact test were used to compare the baseline characteristics between the drug use group and non-drug use group.Cox proportional risk regression model were use to evaluate the Hazard Ratio(HR)of drug-resistance between these two groups.Kaplan-Meier method and cumulative resistance rate curve were used to evaluate the cumulative drug-resistance rate of HIV/AIDS patients during ART.Log-rank test were performed to compare the drug-resistance rates between two groups.Propensity Score Matching(PSM)with 1:1 pairing was performed among subjects in the drug use group and non-drug use group to further verify the effect of drug use on drug-resistance in HIV/AIDS patients during ART.(4)The drug-resistance risk of subjects who had received different baseline antiviral drugs regimen in these two groups were evaluated by means of Survival Analysis.Results(1)Baseline characteristics of subjects between drug and non-drug groups,included initial ART age,gender,marital status,baseline CD4 + T lymphocyte count,baseline WHO clinical staging,baseline antiviral treatment program,and time from diagnosis to start treatment were statistically significant(P < 0.05).(2)Cox proportional risk regression model showed that the drug-resistance density in drug use group was higher than that of non-drug use group(HR = 1.604,95 % CI: 1.308-1.968,P < 0.001).The cumulative drug resistance rate of HIV/AIDS patients in drug and non-drug use groups was analyzed by Kaplan-Meier survival.Thecumulative drug resistance rate in drug use group was higher than that in non-drug use group(Log Rank test: P <0.001).(3)A total of 1288 pairs of study subjects were successfully matched by PSM,1288 cases were in drug and non-drug groups each.The drug resistance density of HIV/AIDS patients in drug use group was higher than that of non-drug use group,which was consistant to the results before performing PSM(HR = 1.662,95 % CI: 1.202-2.298,P =0.002).The cumulative drug resistance rate of the drug use group was higher than that of the non-drug use group(Log rank test: P<0.05).(4)In drug use group,there were no significant difference of drug resistance density,between different regimen of baseline antiviral drugs.In the non-drug group,the drug-resistance density of receiving NRTI + PI treatment was lower than that of receiving any other regimens(HR = 0.393,95 % CI: 0.210-0.735,P = 0.003).And the drug-resistance density of receiving NRTI + NNRTI treatment was not statistically significant to other regimens(HR = 1.036,95 % CI: 0.703-1.529,P =0.857).Survival Analysis showed that,except for NRTI + PI regimen(Log rank: P >0.05),the cumulative drug-resistance rates of HIV/AIDS patients receiving ART in drug use group were higher than that in non-drug use group(Log rank test: P <0.001).ConclusionDrug use may contribute to drug resistance during ART among HIV/AIDS patients,especially in those who received except for nucleoside reverse transcriptase inhibitors and non-nucleoside reverse transcriptase inhibitors regimen. |
PDF Full Text Request