Prevalence of HIV-1 integrase inhibitor resistance before antiviral therapy in some provinces of China in 2022
Objective To investigate the prevalence of integrase inhibitor related resistance in HIV infected patients prior to initiating antiretroviral treatment(ART)in China before widespread use of integrase strand-transfer inhibitors(INSTIs).Methods According to sampling guideline recommended by World Health Organization for the surveillance of drug resistance before ART,a cross-sectional study with two-stage clustering design was conducted.Through the systematic sampling in 9 provinces(cities,autonomous regions),some plasma samples from HIV infected patients before ART treatment were collected for extraction of viral RNA.The complete HIV integrase(IN)gene was amplified by RT-PCR and sequenced.The drug resistance was identified using Stanford HIV Drug Resistance Database.The prevalence of drug resistance to integrase inhibitor before ART among HIV infetected patients was analyzed.Results A total of 2 851 qualified sequences were obtained from 9 provinces(cities,autonomous regions).In the term of subtype distribution,the dominant subtypes were CRF07_BC and CRF01AE,accounting for 1 437(50.4%)and 750(26.3%)cases,respectively.Twenty-seven strains were resistant to INSTIs and the rate of drug resistance was 0.95%.The strains were mainly resistant to RAL and EVG,accounting for 24 and 26 cases,respectively.The main drug resistance mutation sites were R263K(5 cases),T66I/A(2 cases),E138K(2 cases),N155T/S(2 cases),S147G(2 cases),Q148K(2 cases)and Y143S(1 case).The drug resistant strains of the second generation drugs were observed.Twelve patients were resistant DTG and 15 to CAB.Conclusions The overall prevalence of resistance strains of INSTIs among HIV infected patients before ART in some provinces of China in 2022 was low.
Human immunodeficiency virus 1Integrase strand transfer inhibitorsDrug resistance mutation