HIV-1 genotypic drug resistance among patients before initial antiretroviral therapy in Xi'an,2022-2023
Objective To explore the HIV-1 genotypic drug resistance characteristics and subgenotype distribution among HIV-1-infected patients before initial antiretroviral therapy(ART)from 2022 to 2023 in Xi'an city.Methods Initial ART cases from May 2022 to March 2023 in Xi'an were recruited.Three hundred and three anticoagulated venous whole bloods were collected.The nucleic acid was extracted,reversely transcripted,and pol gene segment was amplified by reverse transcription and nested PCR followed by Sanger sequencing.The subgenotypes based on the obtained pol sequences were determined by COMET HIV-1 and confirmed by the HIV BLAST and RIP tools of Los Alamos National Laboratory.Sequence information was resolved for drug resistance using HIVdb Program tool of the Stanford University HIV Drug Resistance Database.Results From the 303 specimens,pol gene was amplified and sequenced successfully in 260 samples.Ten subgenotypes or circulating recombinant forms(CRFs)were detected.The dominant type was CRF07_BC(55.77％)followed by CRF01_AE(32.69％),CRF55_01B(4.62％),and B subgenotype(2.69％).In the analysis,20 cases had resistance-associated mutations(DRMs)before therapy and were highly resistant to first-line drugs.The overall pre-treatment resistance rate of 7.69％.The proportion of drug resistance in CRF01 AE was the highest(3.46％),followed by CRF07_BC(1.92％)and CRF55_01B(1.15％).The incidence of resistance to non-nucleoside reverse transcriptase inhibitors was the highest and the most common were resistance to efavirenz and nevirapine.Conclusions Overall,pre-treatment HIV-1 genotypic drug resistance was relatively high(7.69％)in Xi'an.It is recommended to improve surveillance of pre-treatment drug resistance to analyze the sources of HIV-1 resistant strains and provide data support for the clinical use of medication and personalized treatment.
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