Dong Ke, Ye Li, Leng Yun, Liang Shu, Feng Liao, Yang Hong, Su Ling, Li Yiping, Baloch Saira, He Fangting, Yuan Dan, Pei Xiaofang
West China School of Public Health, No.4 West China Teaching Hospital, Sichuan University.
Sichuan Provincial Center for Disease Control and Prevention, Center for AIDS/STD Control and Prevention.
Tohoku J Exp Med. 2019 Jan;247(1):1-12. doi: 10.1620/tjem.247.1.
Antiretroviral therapy (ART) has been introduced recently and has significantly impacted morbidity and mortality, but can also engender drug resistance. To identify the prevalence of HIV-1 drug resistance (HIVDR) among patients with antiretroviral therapy failure in Sichuan during the period from 2010 to 2016, we carried out a longitudinal study in Sichuan, a province with the highest HIV/AIDS prevalence in China. The data and blood samples were collected from HIV/AIDS patients who received ART for more than half a year. Overall 5,512 sequences were completed from 7,059 ART-failure patients, and 2,499 individuals were identified as drug resistant. Among those with HIVDR mutations identified, 25.37% were against non-nucleoside reverse transcriptase inhibitors (NNRTIs), and 1.60% was against nucleoside reverse transcriptase inhibitors (NRTIs). NRTI-resistant drugs were mainly lamivudine (3TC) (57.77%) and emtricitabine (FTC), while NNRTI-resistant drugs were mainly nevirapine (NVP) (91.13%) and efavirenz (EFV) (72.81%). The most common recombination subtypes of HIV-1 in sequenced samples were CRF07_BC (circulating recombinant form, CRF) (41.42%), followed by CRF01_AE (40.77%). Moreover, drug resistance rate increased with the prolongation of treatment time (χ = 14.758, P < 0.05). The overall prevalence of acquired drug resistance in HIV-1 infected patients in Sichuan was 5.47%, which has remained relatively stable from 2010 to 2016. HIV-1 CRF01_AE and CRF07_BC subtypes were the main epidemic strains, and the possibility of resistance was higher in CRF01_AE subtypes. The current study highlights the importance of acquired drug resistance surveillance over a long period.
抗逆转录病毒疗法（ART）最近已被引入，它对发病率和死亡率产生了重大影响，但也会产生耐药性。为了确定2010年至2016年期间四川省接受抗逆转录病毒治疗失败患者中HIV-1耐药性（HIVDR）的流行情况，我们在四川省开展了一项纵向研究，四川省是中国艾滋病毒/艾滋病患病率最高的省份。数据和血样采集自接受抗逆转录病毒治疗半年以上的艾滋病毒/艾滋病患者。总共从7059例抗逆转录病毒治疗失败患者中完成了5512个序列，其中2499人被确定为耐药。在检测出HIVDR突变的患者中，25.37%对非核苷类逆转录酶抑制剂（NNRTIs）耐药，1.60%对核苷类逆转录酶抑制剂（NRTIs）耐药。对NRTIs耐药的药物主要是拉米夫定（3TC）（57.77%）和恩曲他滨（FTC），而对NNRTIs耐药的药物主要是奈韦拉平（NVP）（91.13%）和依非韦伦（EFV）（72.81%）。测序样本中最常见的HIV-1重组亚型是CRF07_BC（流行重组型，CRF）（41.42%），其次是CRF01_AE（40.77%）。此外，耐药率随治疗时间的延长而增加（χ = 14.758，P < 0.05）。四川省HIV-1感染患者获得性耐药的总体患病率为5.47%，2010年至2016年期间相对稳定。HIV-1 CRF01_AE和CRF07_BC亚型是主要的流行毒株，CRF01_AE亚型产生耐药的可能性更高。当前研究强调了长期进行获得性耐药监测的重要性。
