Objective: To understand the current situation related to genotypic resistance in patients receiving the first-line antiretroviral treatment, but with with virologic failure, in Henan province and to compare the patterns of drug resistance in patients from different areas.
Methods: 276 patients with virologic failure on first-line antiretroviral treatment were selected in three different areas of Henan, in 2010. CD4(+)T cells, virus load and genotypic resistance were measured and tested. Prevalence and mutations related to drug-resistant were analyzed.
Results: The overall prevalence of drug-resistance was 68.48% in 257 patients, with non-nucleoside reverse transcriptase inhibitor (NNRTIs) as 67.70%. Rate of nucleoside reverse transcriptase inhibitor (NRTIs) was 54.09%, and protease inhibitors (PIs) was 1.18%. The prevalence rates of drug-resistance in A, B and C groups were 82.35%, 97.47% and 52.80%, respectively, and withs significant differences (χ2=50.624, P=0.000). The Prevalence rates related to resistance of NNRTIs and NRTIs were also significantly different (χ2=48.771, P=0.000 and χ2=33.912, P=0.000). 26.46% of the samples had M184V/I mutation which was the highest NRTIs mutation among the 257 patients. The prevalence rates on resistance of A and B were 47.06% and 49.37%, higher than that of C (13.04%, χ2=39.905, P=0.000) followed by TAMs, TAMs-1 and TAMs-2 which were 8.56% and 4.28%. C had the lower prevalence of TAMs-1 than A and B (χ2=13.499, P=0.001). 40.47% of the samples harbored≥1 TAM, with T215Y/F having the most, as 33.85%. 31.13% of 257 patients appeared most NNRTIs mutation K103N in this study, with the prevalence rates also significant different (χ2=14.213, P=0.001) in the three areas. Two PIs mutations were detected in 257 patients: M46I/L, (1.17%) and V82F (0.39%). However, none was detected in area A.
Conclusion: Different patterns of drug resistance were found in different areas of Henan province and should be treated differently. The work related to AIDS second-line antiretroviral therapy in Henan should be more opportune, rigorous and standardized.