1.HIV-1 subtypes and drug-resistance mutation sites in HIV/AIDS patients with antiretroviral-therapy failure
Junxiao LIN ; Hongzhu WANG ; Congcong LI ; Ying SHENG ; Guixia LI
Shanghai Journal of Preventive Medicine 2023;35(3):224-228
ObjectiveTo analyze the characteristics of HIV-1 subtypes and drug-resistance mutation sites among HIV-infected patients who received high-efficiency antiretroviral therapy but failed. MethodsA total of 130 plasma samples were collected from the patients who received antiviral treatment for 6 months in Taizhou City of Zhejiang Province in 2021 but failed the treatment and the viral load was ≥1 000 copies·mL-1. Nucleic acid in the samples was extracted, and the pol gene was amplified by nested reverse transcription PCR. After next-generation sequencing, online tools were used to compare and analyze the subtypes and drug-resistant mutation sites. ResultsA total of 110 samples were successfully sequenced. The main HIV-1 subtype was CRF01_AE, accounting for 42.72% (47 cases), followed by CRF07_BC, 35.45% (39 cases); CRF08_BC, 10.00% (11 cases); CRF85_BC , 8.18% (9); and a small number of B subtype, 1.81% (2 cases) and C subtype, 1.81% (2 cases). The online tool comparison showed that there were 67 cases with mutations of drug-resistance sites and 61 cases with drug-resistance. The mutation sites were mainly M184V, K103N, K65R and V181C, and the mutation rates were 20.00% (22 cases), 10.91% (12 cases), 8.18% (9 cases) and 8.18% (9 cases), respectively. These mutation sites caused different degrees of resistance to nucleoside reverse transcriptase inhibitors (NRTI), non- nucleoside reverse transcriptase inhibitors (NNRTI) and protease inhibitors (PI), including 45 cases of NRTI, 61 cases of NNRTI and 2 cases of PI resistance. ConclusionThe HIV infected people who fail the treatment in Taizhou are mainly with the subtypes CRF01_AE and CRF07_BC. The rate of drug-resistance mutation is at a moderate level, mainly due to the mutation of NRTI and NNRTI drug-resistance sites, and a small number of PI drug-resistance sites. Therefore, the antiviral treatment plan for HIV infected people should be reasonably adjusted, and the detection of drug-resistance mutation sites should be strengthened to avoid the generation of transmissible drug-resistance strains.