26. Tỷ lệ thất bại điều trị và đặc điểm gen kháng thuốc HIV ở người bệnh đang điều trị ARV tại Việt Nam (2020 - 2023)

Abstract

In countries with limited financial resources such as Vietnam, drug-resistant HIV poses a significant barrier to the success of antiretroviral therapy. This study followed 2,026 HIV individuals under ARV treatment at 11 healthcare facilities for 24 months to assess treatment failure rates and characterize drug resistance mutations. Eligible participants had undetectable viral load at baseline. Viral load testing was conducted every six months, and genotyping to detect HIV drug resistance mutations was performed in cases of treatment failure. The proportions of treatment failure at 6, 12, 18, and 24 months were 1.23%, 1.09%, 0.64%, and 0.89%, respectively. Among the 67 individuals who experienced treatment failure, 30 patients (44.78%) had detectable drug resistance mutations. The mutations conferred resistance to all three major classes of antiretroviral agents: protease inhibitors, nucleoside reverse transcriptase inhibitors, and non-nucleoside reverse transcriptase inhibitors. These findings demonstrate that routine viral load monitoring, timely genotypic resistance testing, and appropriate treatment adjustment play a critical role in maintaining low treatment failure rates. Expanding access to these services is essential for improving HIV management and limiting the spread of drug-resistant strains in resource-limited settings.