Liu Jia, Yan Jiangzhou, Yang Wenjie, Xue Xiujuan, Sun Guoqing, Liu Chunhua, Tian Suian, Sun Dingyong, Zhu Qian, Wang Zhe
Institute for AIDS/STD Prevention and Cure, Henan Provincial Center for Disease Control and Prevention, Zhengzhou 450016, China.
Institute for AIDS/STD Prevention and Cure, Henan Provincial Center for Disease Control and Prevention, Zhengzhou 450016, China; Email:
Zhonghua Yu Fang Yi Xue Za Zhi. 2015 Nov;49(11):950-5.
To study the condition of HIV-1 drug resistance mutation among failures of first-line antiretroviral therapy in Henan province.
The sub platform of China's legal infectious disease monitoring information reporting system-HIV/AIDS integrated prevention and control data information management system was used to collect the information of patients experiencing first-line antiretroviral treatment failure (virus load ≥ 1 000 copies/ml) more than one year among nine cities of Henan in 2011. A total of 40 cases with no information and 212 cases with incomplete drug resistance results were deleted, and 1 922 cases were included in this study and genotype resistance testing was carried out. Non-conditional logistic regression analysis was used to analyse the influencing factors of drug resistance mutation.
A total of 1 922 cases were included in the analysis. 1 039 cases were males, 833 cases were females, the age was (45.7 ± 12.1) years, 82.73% (1 590) were married, and 87.93% (1 690) were transmitted by blood. 64.20% (1 234) patients acquired drug resistance. Nucleoside reverse transcriptase inhibitor (NRTI), non-nucleoside reverse transcriptase inhibitor (NNRTI) and protease inhibitor (PI) resistance mutations were found in 62.59% (1 203), 49.74% (956) and 0.94% (18) of subjects, respectively. 42.09% (809) of patients harbored NRTI and NNRTI resistance mutations synchronously. ≥ 1TAM was the most commonly emerged NRTI resistance mutation (41.94% (806)), the prevalences of TAM-1 and TAM-2 were 8.48% (163) and 4.24% (81), respectively. K65R/N and Q151M complex existed in 23 and 4 patients, respectively. K103N/S was the most commonly emerged NNRTI resistance mutation (34.32% (659)). Non-conditional logistic regression analysis showed that, factors associated with high drug resistance were the following: transmitted by mother to child (OR = 9.05, 95% CI: 1.14-72.12), clinical stage was IV (OR = 1.70, 95% CI: 1.09-2.66) and 5-year-treated (OR = 1.59, 95% CI: 1.03-2.47). Factors associated with low drug resistance were the following: 1-year-treated (OR = 0.19, 95% CI: 0.13-0.27).
Complex patterns of HIV-1 drug resistance mutations were identified among individuals experiencing failure of first-line antiretroviral therapy in Henan province. Factors associated with high drug resistance were lived in Luohe, Shangqiu, Nanyang, Xinyang, transmitted by mother to child, clinical stage was IV, and 5-year-treated.
研究河南省一线抗逆转录病毒治疗失败患者中HIV-1耐药突变情况。
利用中国法定传染病监测信息报告系统的子平台——艾滋病综合防治数据信息管理系统，收集2011年河南省9个城市中接受一线抗逆转录病毒治疗失败（病毒载量≥1000拷贝/ml）超过1年的患者信息。共删除40例无信息及212例耐药结果不完整的病例，纳入本研究1922例并进行基因型耐药检测。采用非条件logistic回归分析耐药突变的影响因素。
共纳入分析1922例。男性1039例，女性833例，年龄为（45.7±12.1）岁，82.73%（1590例）已婚，87.93%（1690例）经血液传播。64.20%（1234例）患者获得耐药。核苷类逆转录酶抑制剂（NRTI）、非核苷类逆转录酶抑制剂（NNRTI）和蛋白酶抑制剂（PI）耐药突变分别在62.59%（1203例）、49.74%（956例）和0.94%（18例）的研究对象中被发现。42.09%（809例）患者同时存在NRTI和NNRTI耐药突变。≥1TAM是最常见的NRTI耐药突变（41.94%（806例）），TAM-1和TAM-2的发生率分别为8.48%（163例）和4.24%（81例）。K65R/N和Q151M复合突变分别存在于23例和4例患者中。K103N/S是最常见的NNRTI耐药突变（34.32%（659例））。非条件logistic回归分析显示，与高耐药相关因素如下：母婴传播（OR=9.05，95%CI：1.14-72.12）、临床分期为IV期（OR=1.70，95%CI：1.09-2.66）和治疗5年（OR=1.59,95%CI：1.03-2.47）。与低耐药相关因素如下：治疗1年（OR=0.19，95%CI：0.13-0.27）。
在河南省一线抗逆转录病毒治疗失败的个体中发现了复杂的HIV-1耐药突变模式。与高耐药相关因素为居住在漯河、商丘、南阳、信阳、母婴传播、临床分期为IV期和治疗5年。
