HIV/AIDS Patients in China’s Free Antiretroviral Distribution Program Developing Resistance to Drugs
Some HIV/AIDS patients in China who receive antiretroviral drugs at no cost from a government program have begun to develop resistance to the two regimens of drugs offered, and new medications are needed to continue a long-term treatment program, a health official said on Thursday, the South China Morning Post reports. The government has been distributing the drugs to HIV-positive people in certain provinces with especially high HIV prevalence, according to Shao Yiming, director of the virology and immunology office at the National Center for AIDS and Sexually Transmitted Disease Control and Prevention. In 2003, the center chose two counties to monitor to determine the level of drug resistance. According to the study, almost 60% of patients developed a resistance to the drugs nine to 12 months after starting treatment in Henan province's Queshan county, and about 28% of patients developed such a resistance in Anhui province's Fuyang county, the Morning Post reports. Shao said the center has informed the Ministry of Health of its findings and suggested that new antiretroviral drugs be introduced and a national network be established to monitor drug resistance among HIV/AIDS patients (Ma, South China Morning Post, 12/3). The Chinese government estimates that there are 840,000 HIV-positive people in the country and that 80,000 people have AIDS; however, some experts believe that those figures are an underestimate. The United Nations estimates that there are at least one million HIV-positive people in China (Kaiser Daily HIV/AIDS Report, 8/20).
Shao said that patients' misuse of medications -- including "lax" adherence to treatment regimens -- was "mostly to blame" for the widespread drug-resistance problem. In Queshan county, about 32% of patients had a 100% adherence rate, meaning they took their medications as directed and on time. About 51% of the patients being monitored had an adherence rate below 95%, which is the rate required for treatment programs to be effective, Shao said. In Fuyang county, about 80% of patients had a 100% adherence rate and less than 10% had adherence at or below 95%. "They take the drug when they feel like it and stop when they feel like stopping it," Cui Zhaolin, vice president of the Henan Center for Disease Control, said, adding, "Adherence for AIDS patients is so difficult" (South China Morning Post, 12/3).