Analysis of HIV-1 genotype resistance test of HIV antiviral therapy failures, 2019-2020, in Shanxi province
10.3760/cma.j.cn112866-20211220-00212
- VernacularTitle:2019—2020年山西省艾滋病抗病毒治疗失败者HIV-1基因型耐药及其影响因素分析
- Author:
Xiaoli GUO
1
;
Fei ZHANG
;
Xiaoxiang LIU
;
Jin JIAO
;
Xiaoyong NIE
Author Information
1. 山西省疾病预防控制中心，太原 030012
- Keywords:
HIV-1;
Antiviral therapy;
Genotype resistance mutation;
Site
- From:
Chinese Journal of Experimental and Clinical Virology
2022;36(2):176-182
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the HIV-1 drug resistance and related influencing factors of HIV antiviral therapy failures.Methods:Plasma samples were collected from the HIV/AIDS patients who had failed after antiviral therapy for one year at least from 2019 to 2020 for drug resistance gene detection and gene subtype determination, and the influencing factors were analyzed.Results:Among 479 successful samples, 284 had drug resistance gene mutation, the success rate of amplification was 84.18%, the mutation rate was 59.29%, the main gene subtype was CRF01_AE. The related factors of drug resistance gene mutation are CD4 + T lymphocyte count (CD4 count) ( χ2=18.01, P<0.001), HIV-1 subtype ( χ2=10.83, P =0.029) and treatment duration (month) ( χ2=6.24, P=0.044)during drug resistance test. Nucleoside reverse transcriptase inhibitor (NRTI)/non-nucleoside reverse transcriptase inhibitor (NNRTI) double resistance accounted for 54.23%, NNRTI drug resistance accounted for 34.86%, protease inhibitor (PI) drug resistance accounted for 4.23%, NRTI drug resistance accounted for 2.82%, PI/NNRTI double drug resistance accounted for 2.46%, PI/NRTI/NNRTI triple drug resistance accounted for 1.41%. NNRTI mutation mainly occurred at K103N, Y181C, G190A sites. NRTI mutation mainly occurred at M184V, K65R, K70R sites. PI mutation mainly occurred at M46L and Q58E sites. High resistance to nevirapine (NVP) accounted for up to 76.76% of patients with NNRTI resistance. Among the patients with NRTI resistance, 46.83% were highly resistant to emtricitabine (FTC)/lamivudine (3TC). There was no high resistance to PI among 284 drug resistant patients. Conclusions:Patients with low CD4 count, longer treatment time, BC subtype and CRF01_AE subtype had a higher incidence of drug resistance mutations in HIV/AIDS patients in Shanxi province. Most of them are mixed with multi-gene coding region mutations and have high resistance to FTC/3TC and NVP.
