The Epidemic Status And Related Factors Analysis Of Drugresistant Strain In HIV Antiretroviral Treatment Of AIDS In Shandong Province

Objective：Acquired Immunodeficiency Syndrome（AIDS）antivirus therapy is themain measures of prolonged the life，improved the quality of survival and preventedsecondary transmission of HIV infected patients. In this paper，through Drug resistancesurveillance in the AIDS patients on antiretroviral therapy（ART） in Shandong Province，we aims to know the influence factors and production of Human Immunodeficiency Virus（HIV）Drug Resistant Strains in theAIDS patients，and then provide a reference so as tooptimize the AIDS antiviral therapy program，lengthen a patient’s life，and improve thequality life of AIDS patients.Methods： Anticoagulant blood were collected from receiving antiretroviraltreatment and the treatment time≥6months patients17cities in Shandong Province Mayto October2012，fluorescence realtime quantitative （PCR） NucliSens EasyQ used forviral load testing and flow cyto metry tech used for CD4+Lymphocyte count. We amplifiedHIV protease（PR） fulllength and part of the reverse transcriptase（PT） gene RTPCR andnested PCR blood samples in which viral load are greater than or equal1000cp/ml，andthen gene sequencing were take in those successful amplified blood samples，Finally thesequence was submitted to the Stanford University resistant gene databaseresistanceassociated mutation sites produce its sensitivity analysis of the various drugs.Through the establishment of a database survey epidemiological data and blood laboratorytest results the application Epidata software，SPSS17.0statistical software were used forinformation system analysis，to explore the generation of HIVresistant strains in ShandongProvince and its influencing factors.Results：we collected926AIDS patients’ blood，f which7samples’ epidemiologicaldata was missed or incomplete，and919met the inclusion criteria. Viral suppression in the treatment population was89.3%（821/919），and the firstline therapy viral suppression ratewas89.9%（777/864），the secondline was80%（44/55）. Drug detection was made tothe samples which viral load were≥1000cp/ml. the final resistance was3.66%（33/902）.there were22cases of patients who were taking NRTI appeared relatedresistant sites，and the most frequent mutable points were M184V（81.8%）. there were33cases of patients who were taking NNRTI appeared related resistant sites，the highest wasV179D （36.4%）.Multivariate analysis found two influence factors to drug resistance.one was genderand the other was the treatment of life. We didn’t found any statistically significantdifference of drug resistance in patients with other characteristics.Conclusion：1．49patients produced resistant mutation sites in antiviral therapy patients inShandong and the resistance rate of AIDS antiviral therapy patients was3.7%（33/902），it was in a low level.2．The highest frequency were M184V and V179D， all of the resistant mutation siteswere commom and novel mutation were not found.3．The viral inhibition rate of AIDS antiviral therapy patients was89.3%in Shandong Province，and it has achieved good results.4．The single factor analysis found drug resistance had significant difference withCD4+T lymphocyte count and viral load results5． The single factor analysis did not found that significant difference ingeneraldemographic characteristics, routes of infection, treatment programs, years of treatmentand subtypes，Multivariate analysis showed there was no significant difference in age andtreatment programs, gender and years of treatment were the main factors related to drugresistance.