Characteristics of genotypic drug resistance for HIV-1 infected patient with low viral load after antiretroviral therapy in Guangzhou
Objective To analyze the characteristics of developing genotypic drug resistance(DR)among HIV-1 infected patients with viral load(VL)ranging from 50 to 200 copies/mL after antiretroviral therapy(ART)in Guangzhou.Methods HIV-1 infected patients were recruited who received ART for 6 months at the Guangzhou Eighth People's Hospital from January to July 2023,with VL of 50-200 copies/mL.Plasma sample of 0.5 mL was ultracentrifuged at 4 ℃ for concentration of virus.The RNA was extracted and HIV-1 pol gene fragment was amplified by reverse transcriptase PCR(RT-PCR)and nested PCR.The obtained sequences were used for genotyping using COMET HIV-1 subtyping tool.The neighbor-joining tree was constructed using MEGA 11 software to validate the subtypes.The Stanford HIVdb Program was used to interpret the drug resistance.Results A total of 11 799 infected patients were followed up,and 415(3.5％)cases had VL ranging from 50 to 200 copies/mL.Among the 297 patients who completed RT-PCR testing,154 partial pol gene sequences were obtained(52.0％).The main subgenotypes were CRF01-AE(34.4％,53/154)and CRF07-BC(31.2％,48/154).Fifty-seven cases(37.0％,57/154)carried drug resistant mutations(DRMs).The most common DRMs were non-nucleoside reverse transcriptase inhibitors(NNRTIs)related mutation V179E(11.7％,18/154),NRTIs related mutations S68G(6.5％,10/154)and \M184V(5.2％,8/154).The DM rate to any drug was 17.5％(27/154),and the DM rates were 11.7％(18/154)to NVP,11.0％(17/154)to EFV,and 10.4％(16/154)to RPV.Conclusions The infected patient with low VL after ART had hgh prevalence(18.2％-37.0％)of DRMs and developed resistance to many current first-line ART drugs in China to a different degree.The profile of DR among patients with low VL after treatment should be well monitored,to assist optimization of treatment regimens and improvement of clinical outcomes.
Human immunodeficiency virusAntiretroviral therapyLow viral loadGenotypic drug resistance
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