AUTHOR=Liang Shujia , Shen Zhiyong , Yan Jing , Liang Fuxiong , Tang Zhenzhu , Liu Wei , Kan Wei , Liao Lingjie , Leng Xuebing , Ruan Yuhua , Xing Hui , Shao Yiming 

TITLE=Low Virologic Failure and Drug Resistance among HIV-Infected Patients Receiving Hospital-Based ART While Care and Outreach through Community in Guangxi, China

JOURNAL=Frontiers in Public Health

VOLUME=3

YEAR=2015

URL=https://www.frontiersin.org/journals/public-health/articles/10.3389/fpubh.2015.00244

DOI=10.3389/fpubh.2015.00244

ISSN=2296-2565

ABSTRACT=<sec id="ST1"><title>Objectives</title><p>To investigate human immunodeficiency virus (HIV) virologic suppression and drug resistance among HIV-infected patients receiving first-line antiretroviral treatment (ART) in hospitals while community care and outreach through local health workers in Guangxi, China.</p></sec><sec id="ST2"><title>Design</title><p>This was a series of cross-sectional surveys from 2004 to 2012 in Guangxi, supported by the Chinese National HIVDR Surveillance and Monitoring Network Working Group.</p></sec><sec id="ST3"><title>Settings</title><p>Guangxi, China.</p></sec><sec id="ST4"><title>Methods</title><p>Demographic, ART, and laboratory data (CD4<sup>+</sup> cell count, viral load, and drug resistance) were analyzed. Factors associated with virologic suppression were identified by logistic regression analysis.</p></sec><sec id="ST5"><title>Results</title><p>A total of 780 patients were included in this study. The median treatment duration was 20.6 months (IQR 6.6–35.9). Of 780 study participants, 95.4% of patients (744/780) had HIV virologic suppression. Among these, of the 143 patients who were infected through drug injection, only 10 (7.0%) experienced virologic failure, and the overall prevalence of HIV drug resistance was 2.8% (22/789). Factors associated with virologic suppression in the final multivariate models included self-reported missing doses in the past month (compared to not missing doses in the past month, AOR = 0.2, 95% CI: 0.1–0.6) and initial ART regimen without 3TC (compared to initial ART regimen with 3TC, AOR = 0.2, 95% CI: 0.1–0.4). Moreover, the trend chi-square test showed that the proportion of virologic suppression increased over time from 2004 to 2012 (<italic>P</italic> = 0.002).</p></sec><sec id="ST6"><title>Conclusion</title><p>This study first demonstrated that HIV patients infected through various transmission routes can achieve an excellent treatment outcome in hospitals at or above the county level for free first-line ART in Guangxi. It is an important of ART education and adherence to intervention for achieving better treatment outcomes.</p></sec>