Original Article
Study on the relationship between HIV drug resistance and CD4+T cell counts among antiretroviral therapy patients with low viral load
Pengtao Liu, Hui Xing, Lingjie Liao, Xuebing Leng, Jing Wang, Wei Kan, Jing Yan, Zhongbao Zuo, Yuhua Ruan, Yiming Shao
Published 2018-03-06
Cite as Chin J Prev Med, 2018, 52(3): 277-281. DOI: 10.3760/cma.j.issn.0253-9624.2018.03.011
Abstract
ObjectiveTo explore drug resistance of different viral loads, and investigate the relationship between drug resistance and CD4+T cell counts in patients with HIV antiretroviral therapy (ART) in China from 2003 to 2015.
MethodsData were extracted from the Chinese National HIVDR Surveillance database from 2003 to 2015. For this study, the data collected were as follows: having received ART for ≥12 months; 18 years or older; demographic characteristics, information of ART, CD4+T cell counts, viral load (VL) and HIV drug resistance of a total of 8 362 patients were collected. Multi-variables non-conditional logistic regression model was used to study the relationship between viral load, HIV drug resistance and CD4+T cell counts.
ResultsParticipants with age of (41.8±10.5) years were enrolled in this study. Among them, 59.9% (5 009 cases) were men. The percentage of CD4+T cell counts <200 cells/μl in the total population was 17.9% (1 496 cases), the highest was in VL ≥1 000 copies/ml with drug resistance, which was 43.0% (397/923) , followed by VL 50-999 copies/ml with drug resistance, which was 31.1% (69/222), and the lowest was in VL 50-999 copies/ml without drug resistance 13.2% (273/2 068). Compared to VL 50-999 copies/ml without drug resistance, VL<50 copies/ml, VL 50-999 with drug resistance, VL≥1 000 copies/ml without drug resistance, and VL ≥1 000 copies/ml with drug resistance, the OR (95%CI) of CD4 <200 cells/μl were 0.9 (0.7-1.0), 3.2 (2.3-4.4), 2.6 (2.1-3.2), and 4.9 (4.0-5.9), respectively. Among 222 patients with VL 50-999 and HIVDR, the most frequent antiretroviral drugs were EFV and NVP, both of which were NNRTI, and whose percentage both were 94.1% (209 cases). The most frequent mutations were M184V/I (NNRTI), and the percentage was 26.1% (58 cases). The second one was K103N (NNRTI), and the percentage was 22.5% (50 cases). The percentage of V32L/E (PI) and V82A (PI) were lower, they were 0.9% (2 cases) and 0.5% (1 case) respectively.
ConclusionDecreased CD4+T cell counts were associated with HIV drug resistance at low viraemia. In the case of low viral load, the most vulnerable were the NNRTI antiviral drugs such as EFV and NVP.
Key words:
HIV; Anti-HIV agents; Viral load; Drug resistance; CD4+T cell counts
Contributor Information
Pengtao Liu
National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
Hui Xing
Lingjie Liao
Xuebing Leng
Jing Wang
Wei Kan
Jing Yan
Zhongbao Zuo
Yuhua Ruan
Yiming Shao
