Related factors on secondary drug resistance in HIV infected persons receiving antiretroviral therapy in Shandong province: a case-control study / 中华流行病学杂志

ABSTRACT

Objective To explore the causes of secondary drug resistance among HIV infected persons who were receiving antiretroviral therapy in Shandong province,and provide evidence for the improvement of antiretroviral therapy strategy.Methods A case-control study was designed with 1 ∶ 2 matching on case and control groups.Household and face-to-face interview were conducted in October,2015.All the study subjects were screened from both the drug resistant database of antiretroviral therapy of Shandong provincial laboratory and national comprehensive HIV/AIDS database in Shandong.The sample size was estimated as 330 cases including 110 drug resistant and 220 non-drug resistant cases.Subjects were people living with HIV/AIDS (PLWHA) aged 15 or older and received antiretroviral therapy for more than 6 months with records of virus load (VL).Subjects who presented VL above 1 000 copies/ml would receive drug resistance testing.Subjects who were confirmed resistant to with secondary drug,were selected as case group,the rest subjects with non-secondary drug resistance would form the control group.EpiData 3.1 software and SPSS 22.0 software were used to establish a database.Related influencing factors were analyzed with non-conditional stepwise logistic regression model.Results A total of 288 cases were enrolled,including 103 in the case and 185 cases in the control groups,with average age as (37.62 ± 1.06) years and (37.90 ± 0.74)years old,respectively.Most of them were male,married/cohabitant,with education level of junior/senior high school or below and under Han nationality.Results from the multivariate logistic regression model showed that ORs (95％CI) of receiving antiretroviral therapy for 1-3 years,or more than 3 years were equal to 8,80 (3.69-21.00),3.00 (1.20-7.53),compared with receiving antiretroviral therapy less than one year,respectively.OR (95％ CI) of Among the PLWHA that with missing rate above 25.0％ on medication,the OR appeared as 15.41(4.59-51.71),compared with not missing medication.OR (95％ CI) among those who took the medicine themselves was 0.22 (0.07-0.74).Conclusions Factors as duration of treatment,missing rate on medication and taking medicine by oneself were of influence on secondary drug resistance.Other factors as duration on antiretroviral therapy longer than 1 year,missing rate above 25.0％ on medication,were related to the risk on secondary drug resistance.However,if the medicine was taken by oneself,it served as a protective factor for secondary drug resistance.It is necessary to strengthen the intervention and health education programs related to antiretroviral therapy.