Objective: To analyze the situation of AIDS patients who had received replaced therapy program in Henan province.
Methods: 84 AIDS patients had been enrolled into the national free first-line antiretroviral treatment for more than 5 years and would soon be replaced with another antiretroviral treatment program, were selected to a follow-up program to be carried out six months later. Data on CD4(+) t-lymphocyte count, viral load and genotypic resistance were included in the study.
Results: The DDI+AZT+NVP treatment program was used by all the 84 patients at baseline. A replacement by 3TC + AZT + NVP (post first-line) in 31 patients and 3TC + TDF + LPV/r (second-line) in another 53 patients were taken place within a week. All the patients were followed for six months.
Results: showed that: all of the 84 patients appeared an amelioration of CD4(+) t-lymphocyte count median from the baseline of 374.00 cell/µl to 406.50 cell/µl (P = 0.005). Those patients who had changed to second-line treatment program also showed an improvement of CD4(+) t-lymphocyte count median from the baseline of 267.00 cell/µl to 365.00 cell/µl (P = 0.015), while patients who were on the post first-line program with their CD4(+) t-lymphocyte count mean did not show significant change as compared to the baseline (P = 0.158) data. All the 84 patients showed a decrease of virus load median from the baseline of 3.61 log(10)copies/ml to 0.00 log(10) copies/ml (P = 0.000). Both of the two types of patients who had been changed to different programs, had a lower virus load median in the end of the follow-up period (for post first-line: P = 0.007; for second-line: P = 0.000). 13 patients kept their viral load more than 1000 copies/ml, including 5 cases bore more than three thymidine analogue mutations (TAMs) a the end of the follow-up program. Another 4 patients had no resistance mutations detected and no significant variation of viral load (less than 3 times) in the pre- or post-surveys.
Conclusion: AIDS patients who had received long-term first-line antiretroviral treatment program, showed an amelioration six months after changing of the treatment program. Timely and effective testing on drug resistance as well as the strengthening of the follow-up program still seemed to be the link to those patients who were receiving first-line treatment that should not be ignored.