| Objective To investigate the epidemic of the antiretroviral resistance HIV-1 strains in antiretroviral drug-naive and drug-used AIDS patients in some Chinese counties, to evaluate the effect of AIDS patients with antiretroviral therapy in Henan province, and to probe into the variabilities of quasispecies and the phylogenetic analysis of HIV-1 pol gene tentatively.Methods Firstly, from antiretroviral drug-naive AIDS patients in Henan, Hebei and Guizhou province and antiretroviral drug-used AIDS patients in Henan province, to find the general situation, the clinical effect and the drug adherence by the questionnaire investigation. Secondly, the anticoagulatory whole blood samples were collected, to measure virus load, and to count CD4+T lymphocytes. Then, the reverse transcription-polymerase chain reaction ( RT-PCR ) technique was used to amplify the partial pol gene. The sequences were analysed for genotypic antiretroviral resistance, the variabilities of quasispecies and the phylogenetic relation through landing the websites http://hivdb.stanford.edu and http://hiv-web.lanl.gov, under the molecule clone technique and BioEdit, DNAClub, DNASTAR, Clustal X software. All results were statistics analyzed by SPSS 1.0 software package.Results One hundred antiretroviral drug-naive AIDS patients ( 45 in Henan , 10 in Hebei and 45 in Guizhou ) were investigated and the anticoagulatory whole blood samples were collected, the genotypic antiretroviral resistance testing of 61 AIDS patients ( 36 in Henan , 5 in Hebei and 20 in Guizhou ) were completed. The AIDS patients treated with two of NRTIs and one of NNRTIs ( AZT+DDI+NVP ) in Henan province were investigated, 118 AIDS patients who received three months antiretroviral therapy and 166 AIDS patients who received sixmonths antiretroviral therapy were recruited, questionnaire investigations were completed and anticoagulatory whole blood samples were collected, 51 and 83 AIDS patients were carried out genotypic antiretroviral resistance testing respectively.In those patients antiretroviral treated for three and six months, the prevalence rate of antiretroviral resisitance HIV-1 variants were 43.1% ( 22/51 ) and 48.2% ( 40/83 ) respectively, there were no significant differences between the two treatment period ( P>0.05 ) ,but the both were significantly higher than 13.1% ( 8/61 ) in antiretroviral drug-naive patients ( P<0.01 ) . Comparing the three groups of AIDS patients, the antiretroviral resisitance rates of Pis and NRTIs were no significant differences ( P>0.05 ) , but the rate of NNRTIs was significantly higher ( P<0.01 ) in antiretroviral treated patients. In the three groups of AIDS patients, the multi-antiretroviral resisitance rates were 1.6%-. 9.8% and 9.6% ( 1/61, 5/51 and 8/83 ) respectively, showing major resistance to AZT+DDI+DLV+EFV+NVP, and the cross-antiretroviral resisitance rates were 3.3%, 29.4% and 36.1% ( 2/61, 15/51 and 30/83 ) respectively, showing major resistance to NNRTIs. About 90% AIDS patients who had antiretroviral resisitance variants to DLV+NVP were also resisitance to EFV. More than 90% antiretroviral drug-used, but 37.5% antiretroviral drug-naive, AIDS patients with antiretroviral resistance had resistance variants to AZT\ DDI or NVP, there was significant differences ( P<0.01 ) .The high-level resisitance rate in AIDS patients antiretroviral treated for three-month was higher than those in AIDS patients antiretroviral treated for six-month, showing major resistance to DLV, EFV and NVP.The rate of clinical imporvement in those patients with good adherence was 72.8%, whereas in those patients with poor adherence was 25%, there was significant differences ( P<0.01 ) .The drug adherence had significant effect on the improvement of clinical state. In those patients antiretroviral treated for three and six months, 59 were tested virus load, the mean of which were 5.19 log and 5.27 log ( copies/ml ) respectively, and no significant differences ( P>0.05 ) .97 were tested CD4+T lymphocyte counts, the mean of which were 454. 3+45. 34 and...
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