Exploring Virological Failure in HIV/AIDS Treatment: A Cross-sectional Study of Antiretroviral Regimen Efficacy and Predictors in Khorramabad City During 2011 - 2021
| Author | Kiana Shahzamani | en |
| Author | Somaieh Sabzali | en |
| Author | Saman Moetamedi | en |
| Author | Mehdi Birjandi | en |
| Author | Tabassom Zavari | en |
| Orcid | Kiana Shahzamani [0000-0002-7485-6034] | en |
| Orcid | Somaieh Sabzali [0000-0003-1672-6810] | en |
| Orcid | Mehdi Birjandi [0000-0002-0737-8044] | en |
| Orcid | Tabassom Zavari [0000-0001-5799-7575] | en |
| Issued Date | 2026-05-31 | en |
| Abstract | Background: Human immunodeficiency virus (HIV) infection and the ensuing acquired immunodeficiency syndrome (AIDS) remain serious global health threats. With the scale-up of antiretroviral therapy (ART) over the past decade, drug resistance has emerged as a major challenge. Objectives: This study investigated the prevalence of drug resistance among patients with HIV/AIDS referred to counseling centers in Khorramabad, Iran, from 2011 to 2021. Methods: This retrospective cross-sectional study included 279 adults with HIV infection who had received ART for at least 12 months. Demographic characteristics, drug resistance patterns, HIV transmission routes, coinfections, and medication adherence were extracted from medical records and analyzed using SPSS version 21. Chi-square tests were used for categorical variables, and independent t-tests or Mann-Whitney U tests were applied to continuous variables according to the data distribution. A P value ≤ 0.05 was considered statistically significant. Results: The study population included 133 women (47.7%) and 146 men (52.3%), with a mean age of 42.7 ± 8.51 years. Overall, 5.4% of patients were illiterate, and 35.8% had completed diploma-level education. A history of incarceration was reported by 33.3% of participants. The main transmission routes were sexual contact (51.3%) and injection drug use (33.3%). Virological failure occurred in 23.7% of patients, and 96.1% had suitable medication adherence. Baseline CD4+ counts indicated advanced immunosuppression in a notable proportion of patients; 9% had CD4+ counts ≤ 50 cells/μL. Hepatitis B and C markers were detected in 2.9% and 5.7% of patients, respectively. Most patients (83.5%) initiated treatment with a 2-nucleoside reverse transcriptase inhibitor (NRTI) + non-nucleoside reverse transcriptase inhibitor (NNRTI) regimen. Resistance to NNRTIs was common; 64 of the 66 patients with drug resistance had received this regimen. However, the inclusion of lamivudine (3TC) in NNRTI-based regimens had no significant effect on the development of resistance. Conclusions: This study provides valuable local evidence regarding drug resistance in ART, which remains a major limitation in HIV management. These findings highlight the need for individualized therapeutic approaches, resistance surveillance, improved retention in care, and expanded access to regimens with a high genetic barrier. | en |
| DOI | https://doi.org/10.5812/jjm-167579 | en |
| URI | https://brieflands.com/journals/jjm/articles/167579 | en |
| Keyword | HIV/AIDS | en |
| Keyword | Antiretroviral Therapy | en |
| Keyword | Virological Failure | en |
| Keyword | Drug Resistance | en |
| Keyword | Treatment Adherence | en |
| Publisher | Brieflands | en |
| Title | Exploring Virological Failure in HIV/AIDS Treatment: A Cross-sectional Study of Antiretroviral Regimen Efficacy and Predictors in Khorramabad City During 2011 - 2021 | en |
| Type | Research Article | en |
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