ABSTRACT
Objective To analyze the situation of AIDS patients who had received replaced therapy program in Henan province.Methods 84 AIDS patients had been enrolled into the national free first-line antiretroviral treatment for more than 5 years and would soon be replaced with another antiretroviral treatment program,were selected to a follow-up program to be carried out six months later Data on CD4+ tlymphocyte count,viral load and genotypic resistance were included in the study.Results The DDI + AZT + NVP treatment program was used by all the 84 patients at baseline.A replacement by 3TC + AZT + NVP (post first-line) in 31 patients and 3TC + TDF + LPV/r (second-line) in another 53 patients were taken place within a week.All the patients were followed for six months.Results showed that:all of the 84 patients appeared an amelioration of CD4 1 tlymphocyte count median from the baseline of 374.00 cell/μl to 406.50 cell/μl(P=0.005).Those patients who had changed to second-line treatment program also showed an improvement of CD4 + tlymphocyte count median from the baseline of 267.00 cell/μl to 365.00 cell/μl (P=0.015),while patients who were on the post first-line program with their CD4 + tlymphocyte count mean did not show significant change as compared to the baseline (P=0.158) data.All the 84 patients showed a decrease of virus load median from the baseline of 3.61 Iog10copies/ml to 0.00 log10 copies/ml (P=0.000).Both of the two types of patients who had been changed to different programs,had a lower virus load median in the end of the tollow-up period (for post first-line:P=0.007 ；for second-line:P=0.000).13 patients kept their viral load more than 1000 copies/ml,including 5 cases bore more than three thymidine analogue mutations (TAMs) a the end of the follow-up program.Another 4 patients had no resistance mutations detected and no significant variation of viral load (less than 3 times) in the pre-or post- surveys.Conclusion AIDS patients who had received long-term first-line antiretroviral treatment program,showed an amelioration six months after changing of the treatment program.Timely and effective testing on drug resistance as well as the strengthening of the follow-up program still seemed to be the link to those patients who were receiving first-line treatment that should not be ignored.