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[Analysis of HIV genotypic drug resistance among pediatric HIV/AIDS cases with virological failure after free antiretroviral therapy in Yunnan province].

OBJECTIVE
To assess the prevalence and the characteristics of HIV-1 drug-resistance in pediatric HIV/AIDS cases with virological failure after free antiretroviral therapy in Yunnan Province.


METHODS
The data of clinical test and laboratory detection about free antiretroviral therapy in pediatric HIV/AIDS cases from 2005 to 2012 were collected. Then the detection of HIV genotypical drug resistance was performed for the plasmas samples whose viral load were over 1 000 copies/ml after the duration of antiretroviral therapy beyond 6 months. The prevalence and the characteristics of HIV-1 drug resistance were obtained for subsequent analysis.


RESULTS
A total of 73 cases suffered virological failure among 729 cases while 53 cases exhibited the resistance for antiretroviral drugs.So the resistance ratio was 72.6% (53/73) and the general resistance ratio 7.3% (53/729). The prevalent mutations associated with drug resistance were M184V/I, K103N, T215F/Y, G190A, Y181C and K101E at the frequencies of 52.1% (38/73), 30.1% (22/73), 21.9% (16/73), 20.5% (15/73), 15.1% (11/73) and 12.3% (9/73) respectively. The percentage of resistance to NVP, 3TC, EFV, D4T, AZT and ABC was 61.6% (45/73) , 54.8% (40/73) , 47.9% (35/73) , 13.7% (10/73) , 12.3% (9/73) and 5.5% (4/73) respectively. One case developed intermediate resistance to LPV/r.


CONCLUSIONS
The main causes of virological failure is drug resistance.So reducing the incidence and spread of HIV drug resistance is of vital importance in modern era of resource scarcity.