Drug resistance and molecular network analysis of antiretroviral therapy failure in HIVAIDS patients aged 50 years and above in Zhaotong City, Yunnan Province
- Author:
WU Zhixing
;
LIU Jiafa
;
ZHANG Mi
- Publication Type:Journal Article
- Keywords:
Human immunodeficiency virus;
elderly;
drug resistance;
molecular network
- From:
China Tropical Medicine
2024;24(5):542-
- CountryChina
- Language:Chinese
-
Abstract:
Abstract: Objective To understand the characteristics of drug resistance and molecular transmission network of HIV/AIDS patients aged 50 years and above in Zhaotong City, Yunnan Province, from 2020 to 2022, who have failed antiretroviral therapy (plasma viral load≥1 000 copies/mL). Methods The demographic data of HIV/AIDS patients aged 50 years and above with failed antiviral therapy in Zhaotong City from 2020 to 2022 were collected through the antiviral therapy database of Yunnan Province. The plasma of the patients was collected, and the HIV pol gene protease and reverse transcriptase regions were amplified by reverse transcriptase chain reaction, the fragments were spliced using ContigExpress, the sequences were determined, and drug resistance mutations were analyzed using the HIVdb database of Stanford University. Pairwise genetic distances between sequences were calculated using the HyPhy 2.2.4 software with the TN93 model, and a threshold of 1.7% was used to construct the HIV molecular network. Cytoscape 3.7.0 was used to visualize the network. Results A total of 480 HIV/AIDS cases were included, with 417 positive amplifications of plasma samples. Among these, 196 cases were drug-resistant, resulting in a total drug resistance rate of 47.0%. The highest resistance rate was observed in NNRTIs at 45.6% (190/417), followed by NRTIs at 14.4% (60/417), and PIs at a lower rate of 0.2% (1/417). In NNRTIs resistance mutation sites, K103N/E/S mutation sites were dominant, with a mutation rate of 33.3% (139/417). Among the NRTIs resistance mutation sites, M184V/I mutation site was the main one, with a mutation rate of 13.9% (58/417). The mutation rate of PIs resistance sites was relatively lower, at 0.2% (1/417). Through the construction of the molecular transmission network, 88 patients entered the molecular transmission network, with an access rate of 21.1%, forming 21 transmission clusters, among which CRF01_AE formed a large cluster including 37 individuals. Conclusions Compared with studies in other regions of Yunnan Province, the drug resistance rate among the elderly population with antiretroviral therapy failure in this study in Zhaotong City has decreased, and URFs have become the main subtype, suggesting that the transmission relationships among the elderly in Zhaotong City are gradually complicated. Through the construction of a molecular network, it is suggested that CRF01_AE and married or partnered males have the highest network access rate. Interventions should be strengthened among key populations, and diversified efforts in HIV/AIDS prevention and treatment for the elderly should be developed.
- Full text:20250617170433530368.Drug resistance and molecular network analysis of antiretroviral therapy failure in HIVAIDS patients aged 50 years and above in Zhaotong City, Yunnan Province.pdf
