HIV-1 drug resistance and related factors in women of childbearing age infected with HIV-1 in a county of the Liangshan area
Objective This study aimed to analyze the prevalence of acquired drug resistance(ADR)in HIV-1 infected women of childbearing age in a county of the Liangshan area and identify any relevant factors.Methods From January to September 2023,a total of 105 HIV-1 infected women of childbearing age undergoing treatment in a county of the Liangshan area were recruited for this study.Blood specimens were collected and separated for quantitative detection of HIV-1 RNA and DNA,and HIV-1 genotypic drug resistance testing.Results Among the 105 study subjects,HIV-1 RNA levels were predominantly in the range of 0-50 copies/mL(69.5％).Similarly,HIV-1 DNA levels were mainly between 101-1 000 copies/106 cells(67.6％).The primary HIV-1 subtype was the recombinant form CRF07BC(88.6％).Notably the initial combined antiretroviral therapy(cART)regimen for most participants(90.5％)consisted of two nucleoside reverse transcriptase inhibitors(NRTIs)combined with one non-nucleoside reverse transcriptase inhibitor(NNRTI).The overall prevalence of ADR was 20.0％(21 out of 105 subjects).HIV-1 RNA genotypic drug resistance was detected in 11 cases(10.5％),while HIV-1 DNA genotypic drug resistance was identified in 10 cases(9.5％).A total of 32 drug-resistance mutation sites were observed(mutation rate of 30.5％).Nine cases(8.6％)exhibited resistance mutations of primarily related to NNRTIs.The major resistance mutation site was K103KN/N/S.Three cases(2.9％)had resistance mutations mainly associated with NRTIs.M184MV/MI/V was the primary resistance mutation site observed.Seven cases(6.7％)displayed resistance mutations linked to integrase inhibitors(INSTIs),with A128T being the dominant mutation site.Eleven cases(10.5％)showed resistance mutations against both NNRTIs and NRTIs.One case each displayed resistance mutations against NNRTIs,NRTIs,and INSTIs,and both NNRTIs and INSTIs.Importantly,no resistance mutations were detected against protease inhibitors.Univariate logistic regression analysis revealed no statistically significant correlation between the incidence of ADR and factors like cART duration,age,initial cART regimen,cause of HIV infection,and HIV-1 subtype.Conclusions The prevalence of ADR in HIV-1-infected women of childbearing age within this county of the Liangshan area is comparable to the overall drug resistance rate reported in the wider Liangshan region.However,the mutation sites within drug-resistance are complex and diverse.In this study,drug resistance was primarily driven by mutations related to NNRTIs,both as single mutations and in combination with NRTI mutations.Since NNRTIs are a cornerstone component of first-line cART regimens,these findings highlight the importance of strengthening drug resistance monitoring to ensure optimal antiretroviral therapy outcomes.
HIVwomen of childbearing ageacquired drug resistanceantiretroviral therapy
NETL
NSTL
万方数据
