Characteristics of genetic drug resistance among AIDS patients with high/low level of viremia after treatment in Jiangsu Province
Objective To investigate the characteristics of genotypic drug resistance among AIDS patients with high-level viremia(HLV)and low-level viremia(LLV)after antiviral treatment in Jiangsu province.Methods Blood samples were collected from patients receiving antiviral therapy(ART)over 6 months in 2021 with the viral load in plasma＞50 copies/ml..The patients were divided into LLV group and HLV group according to the viral load of 50-999 copies/ml and＞1000 copies/ml.The segments of protease and reverse transcriptase regions in pol gene of human immunodeficiency virus 1(HIV-1)were amplified with an in-house PCR method.The products were sequenced for drug resistance mutation analysis and typing.to analysis drug resistance mutations and subtypes determination.Results The drug resistant rate in LLV was 40.5％among 242 LLV patients,and the rate was 51.34％in the 598 HLV patients.The dominant subtypes in both LLV and HLV groups were CRF01_AE and CRF07_BC.Both subtypes accounted for 38.84％and 35.12％in LLV group,44.82％and 22.75％in HLV group.The difference in the constitutions of subtypes was statistically significant.The dominant mutations in protease region were M46(42.86％)and L33(28.57％)in LLV and HLV groups,respectively.The main mutations in nucleotide and non-nucleotide reverse transcriptase regions in both groups were M184(45.97％,31.92％)and K1 03(26.14％,23.56％),respectively.The main types of drug resistance in both groups were mixed-type resistance followed by single-type resistance.The resistance to nucleoside reverse transcriptase inhibitors with non-nucleoside reverse transcriptase inhibitors was dominant in both LLV and LLV,followed by the resistance to single non-nucleoside reverse transcriptase inhibitors.Conclusions The drug resistance tests in AIDS patients with LLV after ART should be enhanced for early detection of drug resistance and ART failure,thus to block HIV transmission,HIV patients with low viremia to find out drug resistance and reverse the failure of antiretroviral therapy timely in order to end spread of acquired immunodeficiency syndrome.
Human immunodeficiency virusLow-level viremiaHigh-level viremiaGenotypic drug resistanceVirus suppression
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