Analysis of primary drug resistance mutations among 307 newly diagnosed HIV-1-infected individuals in Changsha and the treatment outcome of fully active ART regimen
Objective To observe the status of primary drug resistance mutation(PDRM)among human immunode-ficiency virus type 1(HIV-1)-infected individuals in Changsha and the treatment outcome of fully active antiretroviral ther-apy(ART)regimen on PDRM.Methods Totally 307 newly diagnosed HIV-1-infected individuals were collected,and demographic characteristics and other data were gathered.Plasma samples were collected for CD4+T lymphocyte count,HIV-1 RNA viral load,and genotypic drug resistance testing to determine the PDRM of patients.Patients with PDRM were given fully active ART regimens based on genotypic drug resistance testing results.Patients without PDRM adopted the ini-tial ART regimens recommended by Chinese HIV/AIDS guidelines.We compared the clinical characteristics,treatment regimens and treatment outcome of patients with and without PDRM.Meanwhile,Kaplan-Meier analysis was used to com-pare the prognosis between patients with and without PDRM.Results Among 307 HIV-1-infected individuals,there were 77 patients with PDRM,and 230 patients without PDRM.Among patients with PDRM,67 cases had a single drug re-sistance mutation,while 10 cases had multiple drug resistance mutations.V179D and V179E were the most common drug resistance mutations.There was a statistically significant difference in the distribution of HIV-1 subtypes between patients with and without PDRM(P<0.01).The ART regimen mainly consisted of non-nucleotide reverse transcriptase inhibitors(NNRTI)and two types of nucleotide reverse transcriptase inhibitors(NRTI).The difference in ART regimen between pa-tients with and without PDRM was statistically significant(P<0.05).The virological suppression rate in patients with PDRM remained consistently lower than that patients without PDRM,and the mean survival time was shorter than that of patients without PDRM(both P<0.01).Conclusions In Changsha,the current PDRM mainly targets NNRTI and NRTI drugs,and patients with PDRM are more prone to develop virological adverse events in the early stages of treatment.There-fore,it is necessary to promote the application of fully active ART regimen in this population to reduce viral load as soon as possible and to achieve better prognosis for patients.
human immunodeficiency virusprimary drug resistance mutationantiretroviral therapy
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