Background
Methods
Ethics statement
Study population
Data acquisition
Statistical analysis
Results
Baseline information for HIV-infected patients undergoing long-term second-line antiretroviral therapy
Variable | Category | Numerical value |
---|---|---|
Gender (n. %) | Male | 73(60.8%) |
Female | 47(39.2%) | |
Age (years, IQR) | 45.2(39.8–52.3) | |
Education degree (n, %) | Primary school | 61(50.8%) |
Junior middle school | 40(33.3%) | |
Illiteracy | 19(15.8%) | |
Occupation (n, %) | Farmer | 120(100%) |
Route of infection (n, %) | Paid blood donation(blood transfusion) | 115(95.8%) |
Heterosexual | 3(2.5%) | |
Blood transfusion | 1(0.8%) | |
Unknown | 1(0.8%) | |
Duration of first-line treatment (years, IQR) | 5.0(3.7–5.5) | |
NRTIs drug resistance (n, %) | 68(58.1%) | |
3TC drug resistance | 38(32.5%) | |
TDF drug resistance | 57(48.7%) | |
NNRTIs drug resistance (n, %) | 84(71.8%) | |
Lpv/r drug resistance (n, %) | 0(0) | |
Baseline viral load (lg10) (median, IQR) copies/ml | 4.58 (3.96–5.17) | |
Baseline CD4 + T cells (median, IQR) cells/μl | 170 (100–272) |
Efficacy of long-term second-line antiretroviral treatment
Duration of treatment (month) | Patients followed-up (n) | Viral load (lg10) (median, IQR) copies/ml | Viral load compared with baseline | CD4 + T cells (median, IQR) cells/μl | CD4 compared with baseline |
---|---|---|---|---|---|
Baseline | 120 | 4.58(3.96–5.17) | – | 170(100–272) | – |
6 | 102 | 2.02(1.00–3.84) | P < 0.001 | 230(164–323) | P < 0.001 |
12 | 104 | 1.60(1.00–3.38) | P < 0.001 | 246(185–349) | P < 0.001 |
18 | 82 | 1.77(1.00–3.87) | P < 0.001 | 296(186–394) | P < 0.001 |
24 | 90 | 1.70(1.00–3.90) | P < 0.001 | 316(205–436) | P < 0.001 |
48 | 85 | 1.00(1.00–3.15) | P < 0.001 | 359(236–501) | P < 0.001 |
PI/NRTI/ NNRTI drug resistance mutations among patients with virologic treatment failure during second-line treatment
ID | NRTI Mutations at different time-points | |||||
---|---|---|---|---|---|---|
Baseline | Second-line therapy(months) | |||||
6 | 12 | 18 | 24 | 48 | ||
1001 | M41LM,E44DE,K70KR,L210 W,T215Y | – | – | – | – | K70Q, M184I |
1002 | None | None | None | None | None | None |
1007 | M41 L,D67E,K70R,M184I,T215F,K219Q | M41 L,D67E,T215F,K219Q | – | – | – | – |
1013 | None | – | – | – | None | |
1022 | D67N,K70KR,L74 V,Q151KLMQ,T215IT,K219Q | D67N,K70R,L74 V,M184I, K219Q | D67N,K70R,L74 V, M184I, K219Q | D67N,L74 V, M184I,K219Q | D67N,T69NT,L74 V,M184I, K219Q | M184 V, K219Q |
1026 | M41 L,T69D,V118IV, L210 W,T215Y,K219KR | – | – | – | – | None |
1027 | M41 L,T69ADNT,L74LV,L210 W,T215Y,K219KN | M41 L,T69D, L210 W,T215Y | M41LM,L210LW, T215DY | M41 L,T215Y | T69AT,L210LW, T215D | None |
1028 | None | None | None | None | None | None |
1029 | None |
T69NT
|
M41 L,M184 V, L210 W,T215Y
| – | – | – |
1031 | None | – | – | – | None | None |
1032 | None | – | – | None | None | – |
1036 | None | None | None | None | ||
1045 | None | None | None | _ | _ | None |
1049 | None | None | None | None | ||
1056 | None | None | None | None | None | – |
1062 | None | None | None | None | ||
1067 | None | None | – | None | – | – |
1068 | None | None | None | None | ||
1069 | M41 L,E44DE,D67N,L74 V,V118IV,M184 V,L210GW,T215Y | M41 L,D67N,L74 V,M184 V,L210GW,T215Y | – | – | – | – |
1076 | None | _ | _ |
T69ST,M184 V
|
M184I
| |
1078 | M184MV,T215FIST | – | – | – | None | – |
1083 | M41 L,D67NS,T69NT,K70R,T215F,K219E | – | – | – | – | M41 L, D67N, K70R, T215F, K219E |
1106 | T215FL | – | None | T215FIST | – | – |
1126 | None | – | – | None | – | None |
1134 | None | None | None | None | – | – |
1135 | None | – | None | None | – | – |
1136 | T215SY | – | – | – | – | T215Y |
1155 | M41 L,E44DE,D67N,M184I,L210 W,T215Y,K219KR | M41 L,D67N,M184I,L210 W,T215Y | – | – | – | None |
1161 | None | – | None | – | – | – |
1165 | None | None | – | – | – | – |
1169 | M41 L,L210LW,T215FY | M41 L,L210 W,T215Y | L210 W,T215F | M41 L,M184 V,L210 W,T215Y | – | None |
1170 | None | None | None | – | – | – |
1173 | None | – | – | None | – | – |
1174 | T215Y | T215Y | T215Y | None | – | – |
1175 | V75I | – | V75I,T215Y | – | – | – |
1181 | None | None | None | – | – | – |
1182 | None | – | – | None | – | – |
1195 | M41LM,L210LW,T215Y | M41 L,M184 V,T215Y | – | – | – | – |
1196 | M41 L,T69P,K70R,L210 W,T215FY,K219E | M41 L,T69PS,K70R,M184 V,L210 W,T215Y,K219E | – | – | – | – |
1197 | M184 V | M41LMV,M184 V, T215Y | – | – | – | – |
1198 | T215F | M41 L,T215F | – | M41LM,T215FIST | – | None |
1199 | None | None | – | – | – | – |
1202 | None | – | None | None | – | None |
1203 | M41 L,E44D,L210 W,T215Y | M41 L,E44DE,T69ADNT,V118I,M184 V,L210 W,T215Y | – | – | – | – |
1205 | M41 L,E44D,D67N,K70KR,L210 W,T215Y,K219EK | M41LM,E44DE,D67DN,K70KR,M184 V,L210 W,T215Y,K219E | D67N,K70R,M184 V,L210 W,T215Y,K219E | M41 L,D67N,K70R,M184 V,L210 W,T215Y,K219E | – | – |
ID | NNRTI Mutations at different time-points | |||||
---|---|---|---|---|---|---|
Baseline | Second-line therapy(months) | |||||
6 | 12 | 18 | 24 | 48 | ||
1001 | V106AV,Y181C,H221Y | – | – | – | – | K103 N |
1002 | None | None | None | None | None | None |
1007 | K103 N,Y181C | K103 N,Y181C | – | – | – | – |
1013 | K103 N | – | – | – | K103 N | |
1022 | V90I,K103S,G190A | V90I,K103S,G190A | K103S,G190A | K103S,G190A | K103S,G190A | V90I, K103S, G190A |
1026 | V106A,V108I,F227 L | – | – | – | – | None |
1027 | V108I,Y181C,H221Y | V108I,Y181C,H221Y | V108I,Y181C | V108I,Y181C | V108I,Y181C | V108I, Y181CY |
1028 | None | None | None | None | None | None |
1029 | Y181C,H221HY | V106A,F227 L | ||||
1031 | K103 N | – | – | – | K103 N | – |
1032 | H221Y | – | – | None | None | – |
1036 | None | V179DV | ||||
1045 | K103 N,P225HY,F227FL | K103 N,P225HPSY,F227FL | K103 N,P225HP,F227FL | K103 N | ||
1049 | None | None | None | None | ||
1056 | None | None | None | None | None | – |
1062 | None | None | None | None | ||
1067 | None | None | – | None | – | – |
1068 | K103KN | None | None | None | ||
1069 | K103 N,Y181C,K238H | K103 N,Y181C,K238H | – | – | – | – |
1076 | None | None | None | None | ||
1078 | K101KPQT,K103KN | – | – | – | None | – |
1083 | Y188L | – | – | – | – | Y188L |
1106 | V179IL,Y188FHLY | – | None | Y188FHLY | – | – |
1112 | None | V106IV,G190S | ||||
1126 | None | – | – | None | – | – |
1134 | None | None | None | None | ||
1135 | K103KN | – | K103 N | None | – | – |
1136 | K103S,G190A,H221HY | – | – | – | – | K103S, G190A |
1155 | K101E,G190S | K101E,G190S | – | – | – | None |
1161 | K103 N,Y181C,H221Y | – | K103 N,Y181C | – | – | – |
1165 | None | None | – | – | – | – |
1169 | K101HKNQ,K103KN,G190A | K101H,G190A | K101H,G190A | K101H,G190A | – | None |
1170 | None | None | None | – | – | – |
1173 | None | – | – | None | – | – |
1174 | V106I,V108I,G190A | V106I,V108I,G190A | V108I,G190A | None | – | – |
1175 | K103 N | – | K103 N | – | – | – |
1181 | None | None | None | – | – | – |
1182 | G190S | – | – | None | – | – |
1195 | K103 N,V108I,P225H,K238 T | K103 N,V108I,P225H,K238 T | – | – | – | – |
1196 | V106A,F227Y,M230 L | V106A,F227Y,M230 L | – | – | – | – |
1197 | K101HN,V108I,Y181C,H221Y | K101HN,V108I,Y181C,H221Y | – | – | – | – |
1198 | Y188L | V90I,Y188L | Y188FLY | V106IV | ||
1199 | None | – | – | – | – | None |
1202 | None | – | None | None | – | None |
1203 | K103 N,Y181C | K103 N,Y181C | – | – | – | – |
1205 | V106 M,Y188C | V106 M,Y188CFLR | V106 M,Y188L | V106 M,Y188L | – | – |
Analysis of factors associated with ineffective viral suppression
Predictor | OR(95%CI) |
p
| a OR(95%CI) |
p
| |
---|---|---|---|---|---|
Age(years) | ≤45 | 1 | |||
> 45 | 0.72(0.35,1.48) | 0.367 | |||
Gender | Male | 1 | |||
Female | 0.74(0.36,1.55) | 0.431 | |||
Education degree | illiteracy | 1 | |||
Primary school | 1.23(0.44,3.44) | 0.699 | |||
Junior middle school | 0.91(0.30,2.72) | 0.865 | |||
Baseline CD4 + T cells/μl | CD4 ≤ 50 | 2.86(0.64,12.7) | 0.168 | 2.68(0.35,20.35) | 0.340 |
50 < CD4 ≤ 200 | 1.63(0.77,3,47) | 0.202 | 1.20(0.45,3.19) | 0.450 | |
CD4 > 200 | 1 | ||||
Baseline viral load copies/ml | 1000 < HIV RNA ≤ 10,000 | 1 | 1 | ||
10,000 < HIV RNA ≤ 10,000 | 1.31(0.52,3.31) | 0.567 | 1.07(0.34,3.32) | 0.914 | |
HIV RNA > 100,000 | 3.46(1.27,9.37) | 0.015 | 2.18(0.63,7.61) | 0.221 | |
Duration of first-line therapy (years) | ≤4 | 1 | |||
> 4 | 1.35(0.60,3.04) | 0.475 | |||
Baseline 3TC/TDF resistance | sensitive | 1 | 1 | ||
low/moderate resistance | 0.28(0.12,0.66) | 0.004 | 0.29(0.10,0.83) | 0.022 | |
high resistance | 0.16(0.05,0.49) | 0.001 | 0.10(0.24,0.43) | 0.002 | |
medication adherence | 90–100% | 1 | 1 | ||
< 90% | 9.98(2.00,49.89) | 0.005 | 22.74(3.38,152.59) | 0.001 | |
unknown | 7.48(2.95,18.97) | < 0.001 | 9.40(2.98,29.67) | < 0.001 |