Drug resistance of HIV-1 strain and its associated factors in 273 AIDS patients receiving antiretroviral therapy in Zhejiang province

Objective To investigate the prevalence of HIV-1drug resistance and related factors in AIDS patients receiving antiretroviral therapy in Zhejiang province. Methods The AIDS patients who were aged 18 years and received antiretroviral therapy till the end of 2009 in Hangzhou, Ningbo and Wenzhou were recruited in this study. The questionnaire survey and blood sample collection were conducted among them. The entire protease gene and part of the reverse transcriptase gene were amplified by RT-PCR and nest-PCR for the samples with viral load＞1000 IU/ml, then the gene fragments were sequenced. Mutation of drug resistant gene and drug susceptibility were analyzed by the online tool HIVdb Program developed by Stanford University. Results A total of 273 subjects were enrolled in the analysis. The total drug resistance rate was 7.7%. Engaging in other occupation and having high education level were the protective factors (OR=0.167, 0.181). Being single/divorce/losing of spouse and receiving treatment of D4T+DDI+NVP protocol were risk factors (OR=4.071, 7.467). Conclusion The prevalence of HIV-1drug resistance in AIDS patients receiving antiretroviral therapy was low in Zhejiang, but the variety of drug resistant gene mutation was observed. More attention should be paid to the patients who were with low educated level or without spouse. It is necessary to stop D4T+DDI+NVP treatment as early as possible and remain or increase the patients compliance in order to reduce the emergence of drug resistant strain.