Analysis of drug resistance in HIV-1 infected patients with failed virological inhibition in Guangyuan City from 2017 to 2021
Objective To analyze the drug resistance of human immunodeficiency virus-1(HIV-1)infected patients with failed antiretroviral therapy(ART)in Guangyuan City,and to provide scientific basis for improving the success rate of treatment.Methods Plasma samples from HIV-1 ART failures treated for more than six months in Guangyuan City from 2017 to 2021 were analyzed for drug resistance detection and subtypes.Rates were compared by Chi-square test or Fisher's exact test,and differences were considered statistically significant with P＜0.05.Results There were 332 cases of HIV-1 virological suppression failure infections in Guangyuan City from 2017 to 2021,with a drug resistance rate of 47.3％.Drug resistance rates to nucleoside reverse transcriptase inhibitors(NRTIs),non-nucleoside reverse transcriptase inhibitors(NNRTIs)and protease inhibitors(PIs)were 25.7％,42.1％and 2.4％,respectively,and the difference was statistically significant(x2=129.8,P＜0.001).Among the NRTIs,abacavir(ABC)had the highest resistance rate(23.6％),and M184 resistance mutation site was the most common(42.8％).Among the NNRTIs,efavirenz(EFV)and nevirapine(NVP)had consistent and high resistance rates of 35.3％,and K103 resistance mutation site was the most common(59.4％).Among the PIs,the highest resistance rate was 1.7％for tiranavir(TPV/r),and Q58 resistance mutation site was the most common(2.9％).Genetic subtypes were dominated by circulating recombinant form(CRF)01_AE subtype(40.8％)and CRF07_BC subtype(39.7％).However,CRF85_BC and A subtypes had the highest resistance rate(100％),followed by CRF55_01B subtype(80.0％).Conclusions Antiviral treatment management work in Guangyuan City had achieved a certain success from 2017 to 2021.However,there are still multiple drug-resistant strains and complex drug-resistant gene mutation sites.Drug resistance monitoring and standardized drug use should be strengthened and the quality of antiviral treatment should be improved.
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