Research on Chronic Diseases

HIV Co-infection High Impact Factor Journals

most severely affected by human immunodeficiency virus (HIV) in China, and virological failure on antiretroviral therapy (ART) is serious in this area. Analyses of prevalence and determinants of ART failure, the genetic diversity and drug resistance among people living with HIV (PLWH) helps improve HIV treatment efficiency and prevent HIV transmission. Human immunodeficiency virus (HIV) infections in humans affect more than 37 million individuals worldwide, and approximately 0.85 million people living with HIV (PLWH) live in China. The number of PLWH has increased by 14% from 2016 to 2017 [1]. Liangshan Yi Autonomous Prefecture, as the largest traditional settlement of Yi minority people in China, is the area affected most severely by HIV in China [2]. By the end of 2018, there have been 38,545 PLWH reported in Liangshan, and prevalence rates of HIV in five counties were the highest in China [3, 4]. Effective HIV interventions should be formatted to reduce HIV transmission in this area. Antiretroviral therapy (ART) is highly effective in suppressing HIV, stopping the progression of HIV disease and reducing the risk of HIV transmissions [5, 6]. The rapid scale-up of ART could lead to a significant decline in morbidity and mortality among PLWH, which has been confirmed by many studies [5, 7, 8]. ART is a long-term treatment with the potential for drug toxicity and the emergence of HIV resistance, setting the stage for a suboptimal response or lack of sustained response to therapy that is defined as virological failure. Unfortunately, virological failure not only compromises therapeutic effects for individuals but also endangers the population as a whole [9]. In Liangshan, the virological failure rate is reported to be about 36–45% [10, 11], which is more serious than average in China [12], mainly due to the poor adherence to ART and inadequate drug levels. The high prevalence of virological failure may lead to a large extent of genotypic HIV-1 drug resistance. When an individual is infected with drug resistance mutations, the resistant strain may become the dominant strain for further transmission of HIV-1 drug resistance [13], and consequently increasing the number of antiretroviral-naive patients and reducing their therapeutic effectiveness [14]. Understanding the risk factors of virological failure could help to target HIV prevention and intervention strategies  

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