Objective To analyze the prevalence of transmitted drug resistance(TDR)among HIV-1 treatment-naive patients in a county of Liangshan Prefecture for better understanding local spread of resistant HIV-1 strains and proposing appropriate antiretroviral therapy(ART)regimen.Methods ART treatment-naïve HIV-1 patients were identified and included in this analysis in a county of Liangshan Prefecture from January 2022 to August 2022.Blood samples were collected to prepare plasma samples for quantitative detection and resistance genotyping of HIV-1 RNA.Blood cell samples were used for quantitative detection and resistance genotyping of HIV-1 DNA.Results Overall,135 patients were enrolled,including 75 males(55.6％)and 60 females(44.4％),with a median age of 37.5 years.Majority of the patients(96.3％)were Yi nationality.Sexual transmission was the main pathway of HIV-1 transmission,accounting for 83.0％.TDR was identified in 11 of the 135 patients.The overall prevalence of TDR was 8.1％.The median time from diagnosis of HIV-1 infection to drug resistance testing was 11 days.HIV-1 RNA was 10 001-100 000 copies/mL in 43.7％of the patients.HIV-1 DNA was 101-1 000 copies/106 cells in 55.6％of the patients.Subtype B+C recombinants were the most prevalent HIV-1 subtype(51.9％),followed by CRF07BC recombinants(43.0％).Drug resistance mutation site was identified in 23(17.0％)of the 135 patients,specifically,resistance to non-nucleoside reverse transcriptase inhibitors(NNRTIs),mainly efavirenz and or nevirapine,primarily conferred by K103N mutation in 16(11.9％)patients;resistance to integrase inhibitors(INSTIs),mainly,elvitegravir and raltegravir,primarily conferred by E157Q mutation in 6(4.4％)patients;and resistance to both NNRTIs and INSTIs in 1(0.7％)patient.Univariate and multivariate logistic regression analyses demonstrated that young patients(≤ 30 years of age)had higher risk of TDR compared with older patients(age＞30 years of age).Conclusions The clinicians should be aware of the TDR among HIV-1 treatment-naive patients in a county of Liangshan Prefecture.The patients 30 years of age or younger have higher risk of TDR than those older than 30 years of age.It is recommended that HIV patients should be tested for HIV-1 drug resistance before receiving ART.
关键词
耐药突变位点/传播性耐药/人类免疫缺陷病毒/抗反转录病毒治疗
Key words
drug resistance mutation site/transmitted drug resistance/HIV/antiretroviral therapy
维普
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