HIV-1 Subtype Diversity and Factors Affecting Drug Resistance among Patients with Virologic Failure in Antiretroviral Therapy in Hainan Province, China, 2014-2020.

De E YU; Yu Jun XU; Mu LI; Yuan Yang; Hua Yue Liang; Shan Mei Zhong; Cai Qin; Ya Nan Lan; Da Wei LI; Ji Peng YU; Yuan Pang; Xue Qiu Qin; Hao Liang; Kao Kao Zhu; Li YE; Bing Yu Liang

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HIV-1 Subtype Diversity and Factors Affecting Drug Resistance among Patients with Virologic Failure in Antiretroviral Therapy in Hainan Province, China, 2014-2020.

Author: De E YU ^{1
,

2} ; Yu Jun XU ³ ; Mu LI ⁴ ; Yuan YANG ⁵ ; Hua Yue LIANG ⁴ ; Shan Mei ZHONG ⁴ ; Cai QIN ⁴ ; Ya Nan LAN ⁶ ; Da Wei LI ⁴ ; Ji Peng YU ⁷ ; Yuan PANG ⁴ ; Xue Qiu QIN ⁴ ; Hao LIANG ^{1
,

5} ; Kao Kao ZHU ³ ; Li YE ^{1
,

5} ; Bing Yu LIANG ^{1
,

5}
Author Information

1. Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning 530021, Guangxi, China
2. International School of Public Health and One Health, Hainan Medical University, Haikou 571199, Hainan, China.
3. Prevention and Treatment Department, the Fifth People's Hospital of Hainan Province & Affiliated Dermatology Hospital of Hainan Medical University, Haikou 570102, Hainan, China.
4. Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning 530021, Guangxi, China.
5. Collaborative Innovation Centre of Regenerative Medicine and Medical BioResource Development and Application Co-constructed by the Province and Ministry, Life Sciences Institute, Guangxi Medical University, Nanning 530021, Guangxi, China.
6. Oncology Medical College, Guangxi Medical University, Nanning 530021, Guangxi, China.
7. The First Clinical Medical College, Guangxi Medical University, Nanning 530021, Guangxi, China.
Publication Type:Journal Article
Keywords: Antiretroviral therapy; Drug resistance; HIV-1 subtypes; Virological failure
MeSH: Humans; Reverse Transcriptase Inhibitors/therapeutic use*; HIV-1/genetics*; Cross-Sectional Studies; Phylogeny; Anti-HIV Agents/therapeutic use*; Drug Resistance, Viral/genetics*; HIV Infections/epidemiology*; Mutation; China/epidemiology*; Prevalence; Genotype
From: Biomedical and Environmental Sciences 2023;36(9):800-813
CountryChina
Language:English
Abstract: OBJECTIVE:This study aimed to determine the HIV-1 subtype distribution and HIV drug resistance (HIVDR) in patients with ART failure from 2014 to 2020 in Hainan, China.
METHODS:A 7-year cross-sectional study was conducted among HIV/AIDS patients with ART failure in Hainan. We used online subtyping tools and the maximum likelihood phylogenetic tree to confirm the HIV subtypes with pol sequences. Drug resistance mutations (DRMs) were analyzed using the Stanford University HIV Drug Resistance Database.
RESULTS:A total of 307 HIV-infected patients with ART failure were included, and 241 available pol sequences were obtained. Among 241 patients, CRF01_AE accounted for 68.88%, followed by CRF07_BC (17.00%) and eight other subtypes (14.12%). The overall prevalence of HIVDR was 61.41%, and the HIVDR against non-nucleoside reverse transcriptase inhibitors (NNRTIs), nucleotide reverse transcriptase inhibitors (NRTIs), and protease inhibitors (PIs) were 59.75%, 45.64%, and 2.49%, respectively. Unemployed patients, hypoimmunity or opportunistic infections in individuals, and samples from 2017 to 2020 increased the odd ratios of HIVDR. Also, HIVDR was less likely to affect female patients. The common DRMs to NNRTIs were K103N (21.99%) and Y181C (20.33%), and M184V (28.21%) and K65R (19.09%) were the main DRMs against NRTIs.
CONCLUSION:The present study highlights the HIV-1 subtype diversity in Hainan and the importance of HIVDR surveillance over a long period.