OBJECTIVETo find out the mechanism of drug resistance by detecting the mutations of HIV RNA in patients who failed in the anti-HIV therapy, to direct the clinical use of anti-HIV drugs and to complement the existing drug resistant database.

METHODSHIV RNA and DNA were extracted from the plasma of 10 HIV-infected patients who developed drug resistance in the Clinic of AIDS, Ruhr University, Bochum, Germany. Then HIV-RNA was amplified in the reverse transcriptase (RT) and protease regions by polymerase chain reaction (PCR). After purified, the PCR products was sequenced. The acquired sequences were compared with the international standard strain HXB2CG and the resistant database of Stanford University.

RESULTSSome mutations were found to cause the corresponding resistance to certain drugs and were consistent with the clinical results. Some mutations existed in some patients, such as V179I in RT and K20T, K20I in protease, which hadn't been reported in the resistant database of Stanford University yet.

CONCLUSIONPatients who fail in HAART have different mutations in RT and protease regions. Mutations such as V179I in RT and K20T, K20I etc in protease may be related to drug resistance.

Adult ; Antiretroviral Therapy, Highly Active ; Drug Resistance, Viral ; HIV Infections ; drug therapy ; virology ; Humans ; RNA, Viral ; blood ; Treatment Failure

Adult ; Antibodies, Anticardiolipin ; blood ; Antiretroviral Therapy, Highly Active ; Female ; Femur Head Necrosis ; etiology ; HIV Infections ; complications ; drug therapy ; immunology ; Humans

Biomarkers are very useful in the diagnosis and identification of neurocognitive impairments (NCIs) or disorders (NCDs) in HIV-infected individuals, and in particular, blood biomarkers have become more promising because they are cheap and easy to obtain or accept. A systematically literature retrieval was conducted by using PubMed, CNKI, Wanfang and VIP databases for studies about blood biomarkers of neurocognitive impairment of HIV-infected individuals in 2008-2017, according to the inclusion and exclusion criteria. Finally, a total of 43 related articles were included for this systematic review for the purpose of providing scientific evidence for further research and clinical practices.
Adult ; Anti-Retroviral Agents/therapeutic use* ; Biomarkers/blood* ; Cognition Disorders/diagnosis* ; Female ; HIV Infections/drug therapy* ; Humans ; Neurocognitive Disorders/diagnosis*

OBJECTIVETo survey the prevalence of HIV-1 drug resistance in patients newly diagnosed as HIV positive and who were younger than 25 years of age but had not received treatment with antiretroviral treatment (ART) in Hunan province.

METHODSSerum specimens of HIV infected individuals were collected and HIV-1 pol genetic mutations associated with drug resistance were identified with PCR and interpreted with Stanford HIV Drug Resistance Database.

RESULTSA total number of 69 patients whose HIV sequences were amplified successfully with 2 (2.9%) specimens appeared mutations associated with HIV-1 drug resistance in the reverse transcriptase region, including one as V75M and the other one as K103N and V181C. Data showed that the prevalence of drug resistance in Hunan was 2.9%.

CONCLUSIONThe first line regiments of national ART seemed still effective. Most of the AIDS patients did not need to be tested on drug resistance status before starting ART. However, it is important to start HIV drug resistance surveillance in no time.

Adolescent ; Adult ; Anti-HIV Agents ; pharmacology ; Child ; Child, Preschool ; China ; Cross-Sectional Studies ; Drug Monitoring ; Drug Resistance, Viral ; Female ; HIV Infections ; blood ; drug therapy ; HIV-1 ; drug effects ; Humans ; Male ; Prevalence ; Young Adult

BACKGROUNDThe pharmacokinetics of zidovudine (AZT) are possibly influenced by weight, age, sex, liver and renal functions, severity of disease, and ethnicity. Currently, little information is available on the steady-state pharmacokinetics of AZT in Chinese HIV-infected patients. The current study aimed to characterize the steady-state pharmacokinetics of AZT in a Chinese set-up.

METHODSEleven Chinese HIV-infected patients were involved in the steady-state pharmacokinetic study. In total, 300 mg of AZT, as a part of combination therapy, was given to patients, and serial blood samples were collected for 12 hours. The samples were measured by a high-performance liquid chromatography (HPLC) assay, and the results were analyzed by both the non-compartment model and the one-compartment model.

RESULTSThe C(max) of AZT in Chinese patients was higher than that in non-Asian patients. The half-life of AZT, analyzed by the non-compartment model (P = 0.02), in male patients ((1.02 ± 0.22) hours) was shorter than that of AZT in female patients ((1.55 ± 0.29) hours). The AZT clearance, analyzed by the one-compartment model (P = 0.045), in male patients ((262.60 ± 28.13) L/h) was higher than that in female patients ((195.85 ± 60.51) L/h).

CONCLUSIONThe present study provides valuable information for the clinical practice of AZT-based highly active antiretroviral therapy in a Chinese set-up.

Adult ; Anti-HIV Agents ; pharmacokinetics ; therapeutic use ; Asian Continental Ancestry Group ; Female ; HIV Infections ; blood ; drug therapy ; Humans ; Male ; Middle Aged ; Zidovudine ; pharmacokinetics ; therapeutic use

To evaluate factors associated with human immunodeficiency virus type 1 (HIV-1) proviral DNA load, we conducted a cross-sectional study of 36 chronically HIV-1- infected individuals with undetectable plasma viral RNA. We used real-time polymerase chain reaction to determine the number of HIV-1 proviral DNA copies per 10(6) peripheral blood mononuclear cells. The mean level of plasma viral RNA when the CD4+ T cell count was above 500 cells/microliter without highly active antiretroviral therapy (HAART) was significantly associated with proviral DNA load at the time of undetectable plasma HIV RNA with HAART. Strategies to reduce the level of plasma viral RNA when patients' CD4+ T cell counts are above 500 cells/microliter without HAART could help reduce HIV-1 proviral DNA load.
Anti-HIV Agents/therapeutic use ; Antiretroviral Therapy, Highly Active ; CD4-Positive T-Lymphocytes/virology ; Cross-Sectional Studies ; DNA, Viral/*analysis ; Female ; HIV Infections/drug therapy ; HIV-1/*genetics ; Humans ; Male ; Polymerase Chain Reaction ; Proviruses/*genetics ; RNA, Viral/blood

BACKGROUNDThe incidence of HIV-1-related infection diseases and the mortality of AIDS have dramatically decreased since highly active antiretroviral therapy began to be used clinically in China in 1999. And we initiated a second clinical trial using a combination of Efavirenz and Indinavir to observe the effects of the immunoreaction.

METHODSTwenty patients with laboratory-confirmed chronic HIV-1 infection were recruited. Blood samples were collected initially and during the weeks after initiation of treatment. Within 48 hours of blood sampling, peripheral blood plasma and mononuclear cells were separated using routine methods. HIV-1 viral load was measured in thawed plasma samples. Within 48 hours of peripheral blood sampling, CD4(+) and CD8(+) T cell subsets were enumerated.

RESULTSThe drug regimen was efficient in reducing HIV-1 plasma viral load and increasing total CD4(+) T cell counts. The percentage of CD4(+) and CD8(+) T cell subsets expressing CD38 and HLA-DR activation markers was positively correlated with plasma viral load and tended to normalize.

CONCLUSIONSThe combination of Efavirenz and Indinavir was generally well tolerated and efficient at reducing HIV-1 RNA. Furthermore, the treatment improved the immunological function.

ADP-ribosyl Cyclase ; blood ; ADP-ribosyl Cyclase 1 ; Adult ; Aged ; Anti-HIV Agents ; administration & dosage ; Antigens, CD ; blood ; Benzoxazines ; CD4-CD8 Ratio ; Chronic Disease ; Drug Therapy, Combination ; Female ; HIV Infections ; drug therapy ; immunology ; virology ; HIV Protease Inhibitors ; administration & dosage ; HIV-1 ; HLA-DR Antigens ; blood ; Humans ; Indinavir ; administration & dosage ; Male ; Membrane Glycoproteins ; Middle Aged ; Oxazines ; administration & dosage ; Viral Load

OBJECTIVE: To observe the dynamic changes of 3 types of viral reservoir cells (NK cells, T lymphocytes and monocytes), and its relationship with treatment effect in Chinese HIV-1 infected patients receiving highly active antiretroviral treatment (HAART) for 2 years. METHODS: A total of 40 chronic HIV-1-infected adults who initiated HAART were enrolled in this study and followed up for 2 years. Peripheral whole blood was obtained from each patient at baseline (0 month), 6, 12, 18 and 24 months. Real-time fluorescent quantitative PCR was used to detect the HIV-1 RNA in the plasma and HIV-1 DNA in NK cells, T lymphocytes and monocytes. All the data were statistically analyzed. RESULTS: CD4 count increased with the decrease of the viral load during HAART. After HAART initiation, HIV-1 DNA showed a significant decrease in NK cells, T lymphocytes and monocytes. The HIV-1 DNA from T lymphocytes, NK cells and monocytes correlated positively with the HIV- 1 RNA (P<0.05) while NK cells and T lymphocytes correlated negatively with CD4+ T cell count. However we did not find significant correlation between CD4+ T cell count and HIV-1 DNA in monocytes at the baseline of HAART. CONCLUSION This study found that NK cell was an important HIV cellular reservoir besides T lymphocytes and monocytes. T lymphocytes may be the main long lasting HIV reservoir. HIV-1 proviral DNA may play an important role in the efficacy of treatment and monitoring the disease progression.
Adult ; Antiretroviral Therapy, Highly Active ; DNA, Viral ; analysis ; Female ; HIV Infections ; drug therapy ; virology ; HIV-1 ; genetics ; Humans ; Killer Cells, Natural ; virology ; Male ; Middle Aged ; Monocytes ; virology ; RNA, Viral ; blood ; T-Lymphocytes ; virology ; Viral Load

Metabolic syndrome is an important long term complication in chronic asymptomatic HIV-infected subjects under highly active antiretroviral therapy (HAART), because it can contribute to morbidity and mortality via cardiovascular disease (CVD). Therefore, a predictive marker for early detection of metabolic syndrome may be necessary to prevent CVD in HIV-infected subjects. Retinol-binding protein-4 (RBP-4) has been shown to be associated with metabolic syndrome in various non-HIV-infected populations. We performed a cross-sectional study to evaluate whether serum RBP-4 levels are correlated with metabolic syndrome in HIV-infected subjects receiving HAART. In total, 98 HIV-infected Koreans who had been receiving HAART for at least 6 months were prospectively enrolled. Metabolic syndrome was diagnosed according to the Adult Treatment Panel III criteria, and serum RBP-4 concentrations were measured using human RBP-4 sandwich enzyme-linked immunosorbent assay. Serum RBP-4 levels were significantly higher in HIV-infected subjects receiving HAART with metabolic syndrome (n=33, 33.9+/-7.7 microg/mL) than in those without it (n=65, 29.9+/-7.2 microg/mL) (p=0.012). In multivariate linear regression analysis, the number of components of metabolic syndrome presented and waist circumference were independently, significantly correlated with RBP-4 (p=0.018 and 0.030, respectively). In conclusion, we revealed a strong correlation between RBP-4 and the number of components of metabolic syndrome in HIV-infected subjects receiving HAART.
Adult ; *Antiretroviral Therapy, Highly Active ; Enzyme-Linked Immunosorbent Assay ; Female ; HIV Infections/*blood/*drug therapy ; Humans ; Male ; Metabolic Syndrome X/*blood/*drug therapy ; Middle Aged ; Retinol-Binding Proteins, Plasma/*metabolism

BACKGROUND/AIMS: Advanced human immunodeficiency virus (HIV) infection, despite sustained viral suppression by highly active antiretroviral therapy (HAART), is a risk factor for poor immunologic recovery. However, some patients with advanced infection do show immunologic recovery. In this study, predictive factors of immunologic recovery were analyzed in advanced HIV patients showing sustained viral suppression. METHODS: A case-control study was conducted in HIV-infected adult patients with HIV-1 RNA < 50 copies/mL maintained for 4 years or longer and who were receiving HAART. Advanced HIV infection was defined as a baseline CD4 T cell count < 200/mm3. Immunologic responders were defined as patients showing immunologic recovery (CD4 T cell counts > or = 500/mm3 at 4 years with HAART). To analyze the CD4 T cell kinetics, the CD4 slope (monthly changes in the CD4 T cell count) was estimated for each patient using a linear regression between the CD4 T cell count and the time since HAART initiation. RESULTS: Of 102 eligible patients, 73 had advanced HIV, and 33 (45.2%) showed immunologic recovery. The median CD4 slopes (cells/mm3 per month) during 0 to 6 and 0 to 12 months of HAART in the 73 advanced patients were significantly higher in responders than in non-responders (0 to 6 months, 38.6 vs. 22.8; 0 to 12 months, 24.5 vs. 13.5). Multivariate analyses showed opportunistic infections at the start of HAART (adjusted odds ratio [OR], 0.28) and a CD4 slope > or = 20 during 0 to 12 months of HAART (adjusted OR, 10.10) were independently associated with immunologic recovery. CONCLUSIONS: The CD4 slope can be an early predictor of long-term immunologic recovery in advanced HIV patients.
Adult ; Anti-HIV Agents/therapeutic use ; Antiretroviral Therapy, Highly Active ; Biomarkers/blood ; *CD4 Lymphocyte Count ; Case-Control Studies ; Chi-Square Distribution ; Female ; HIV Infections/*diagnosis/drug therapy/*immunology/virology ; HIV-1/drug effects/genetics/*immunology ; Humans ; Linear Models ; Logistic Models ; Male ; Middle Aged ; Monitoring, Immunologic/*methods ; Multivariate Analysis ; Odds Ratio ; Predictive Value of Tests ; RNA, Viral/blood ; Time Factors ; Treatment Outcome ; Viral Load