Objective: To analyze the risk factors of the firstline antiretroviral treatment failure in patients with HIV/AIDS in Nanjing area in order to reduce the failure rate of firstline regimen. Methods: The evaluation of demographic information, follow-up data and risk factors of treatment failure was conducted retrospectively in HIV/AIDS patients who failed to receive free first-line antiretroviral therapy and changed the free second-line regimen containing lopinavir/ritonavir (LPV/r) in Nanjing Second Hospital from January 2016 to September 2019, followed up to March 2020. Results:  Among 1 739 HIV/AIDS patients, 44 (2.5%) switched to second-line treatment with LPV/r due to virologic failure. Baseline CD4⁺T lymphocyte counts <200 cells/μL (OR=13.105, 95% CI: 5.025-34.176) and baseline viral load ≥1×105copies/mL (OR=2.491, 95% CI: 1.210-5.128) were risk factors of first-line treatment failure. First-line treatment failure was not associated with gender, age, marital status, body mass index, route of transmission, interval from the confirmation to initial treatment, or access to essential medical insurance. Conclusion:  First-line regimen failure was associated with lower baseline CD4⁺ T lymphocyte counts and higher baseline viral load. We should focus on patients with these risk factors.

［Key words］HIV；AIDS；antiretroviral therapy；first-line antiretroviral treatment；virologic failure；risk factors; CD4⁺ T lymphocyte；viral load