Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2010 Jan 15;50(2):264-71.
doi: 10.1086/649215.

Predictors of virologic failure in HIV-1-infected adults receiving first-line antiretroviral therapy in 8 provinces in China

Ye Ma  1 , Decai Zhao, Lan Yu, Marc Bulterys, Matthew L Robinson, Yan Zhao, Zhihui Dou, Philippe Chiliade, Xiaoyu Wei, Fujie Zhang
Affiliations

Predictors of virologic failure in HIV-1-infected adults receiving first-line antiretroviral therapy in 8 provinces in China

Ye Ma et al. Clin Infect Dis. .

Abstract

Background: Despite poor primary health care systems, free antiretroviral therapy (ART) has been available in China for >5 years. Virologic outcomes in Chinese patients receiving ART have not been described on a national level.

Methods: A multistage cluster design was used in 8 provinces to randomly select patients who had been receiving first-line ART for at least 6 months, who were stratified into 3 treatment-duration groups. Viral load testing and patient interviews were conducted, and data were linked with national treatment database information. Collected data were analyzed for association with viral suppression by means of multivariate modeling. Adequate viral suppression was defined as a viral load of <400 copies/mL.

Results: Of 5256 patients receiving ART, 3894 met the eligibility criteria, among whom 1153 were analyzed. Overall, 72% demonstrated viral suppression, and 82%, 73%, and 67% of the participants receiving ART for 6-11, 12-23, and > or = 24 months, respectively, experienced viral suppression (P < .001). In a multivariate model, treatment given at locations other than county-level hospitals was less likely to achieve viral suppression, with greater odds for inadequate virologic response found at village clinics (odds ratio [OR], 5.4; 95% confidence interval [CI], 2.9-10.1), township health centers (OR, 3.1; 95% CI, 1.7-5.6), and public health clinics (OR, 3.1; 95% CI, 1.7-5.6). Patients receiving didanosine-based regimens were more likely to experience an inadequate virologic response than were those receiving lamivudine-based regimens (OR, 3.9; 95% CI, 2.7-5.7).

Conclusions: China's national ART program is largely successful at suppressing viral load. Care received outside of hospitals and regimens containing didanosine were associated with less favorable virologic outcomes.

PubMed Disclaimer

Conflict of interest statement

Potential conflicts of interest. P.C. has received a research grant from Tibotec (REACH Initiative). Y.M, D.Z., L.Y., M.B., M.R., Y.Z., Z.D., X.W., and F.Z. No conflict.

Figures

Figure 1
Figure 1
Virologic response divided by treatment duration and facility type for patients with initial regimens containing lamivudine (A), for patients with initial regimens containing didanosine (B), and for the whole study population (C) among a stratified random sample of patients in 8 provinces in China, 2007
See this image and copyright information in PMC

References

    1. UNAIDS/WHO Working Group on Global HIV/AIDS and STI Surveillance. Epidemiological Fact Sheets on HIV and AIDS. [Accessed 24 Dec 2008]. 2008 Update. Available at: http://www.who.int/globalatlas/predefinedReports/EFS2008/full/EFS2008_CN....
    1. Xu JQ, Wang JJ, Han LF, et al. Epidemiology, clinical and laboratory characteristics of currently alive HIV-1 infected former blood donors naive to antiretroviral therapy in Anhui Province, China. Chin Med J (Engl) 2006;119:1941–1948. - PubMed
    1. Wu Z, Sullivan SG, Wang Y, Rotheram-Borus MJ, Detels R. Evolution of China's response to HIV/AIDS. Lancet. 2007;369:679–690. - PMC - PubMed
    1. Qian HZ, Vermund SH. Editorial commentary: antiretroviral therapy for former plasma donors in China: saving lives when HIV prevention fails. Clin Infect Dis. 2008;47:834–836. - PubMed
    1. Watts J. Sex, drugs, and HIV/AIDS in China. Lancet. 2008;371:103–104. - PubMed

Publication types

Substances