2012 年至 2017 年中国中南地区湖南省接受抗逆转录病毒治疗的患者中获得性耐药突变的流行情况。

Prevalence of acquired drug resistance mutations in antiretroviral- experiencing subjects from 2012 to 2017 in Hunan Province of central South China.

机构信息

Hunan Provincial Center for Disease Control and Prevention, No.450 Section 1 Furongzhong middle Road, Kaifu District, Changsha, 410005, Hunan Province, China.

University of California at Los Angeles, 405 Hilgard Avenue, Los Angeles, CA, 90095, USA.

出版信息

Virol J. 2020 Mar 17;17(1):38. doi: 10.1186/s12985-020-01311-3.

DOI:10.1186/s12985-020-01311-3

PMID:32183889

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7079350/

Abstract

BACKGROUND

There are few data on the prevalence of acquired drug resistance mutations (ADRs) in Hunan Province, China, that could affect the effectiveness of antiretroviral therapy (ART).

OBJECTIVES

The main objectives of this study were to determine the prevalence of acquired drug resistance (ADR) the epidemic characteristics of HIV-1-resistant strains among ART-failed HIV patients in Hunan Province, China.

METHODS

ART-experienced and virus suppression failure subjects in Hunan between 2012 and 2017 were evaluated by genotyping analysis and mutations were scored using the HIVdb.stanford.edu algorithm to infer drug susceptibility.

RESULTS

The prevalence of HIV-1 ADR were 2.76, 2.30, 2.98, 2.62, 2.23and 2.17%, respectively, from 2012 to 2017. Overall 2295 sequences were completed from 2932 ART-failure patients, and 914 of these sequences were found to have drug resistance mutation. The most common subtype was AE (64.14%), followed by BC (17.91%) and B (11.50%). Among those 914 patients with drug resistance mutations,93.11% had NNRTI-associated drug resistance mutations, 74.40% had NRTI drug resistance mutations (DRMs) and 6.89% had PI DRMs. Dual-class mutations were observed in 591 (64.66%) cases, and triple-class mutations were observed in 43 (4.70%) cases. M184V (62.04%), K103N (41.90%) and I54L (3.83%) were the most common observed mutations, respectively, in NRTI-, NNRTI- and PI-associated drug resistance. 93.76% subjects who had DRMs received the ART first-line regimens. CD4 count, symptoms in the past 3 months, and ART adherence were found to be associated with HIV-1 DR.

CONCLUSIONS

This study showed that although the prevalence of HIV-acquired resistance in Hunan Province is at a low-level, the long-term and continuous surveillance of HIV ADR in antiretroviral drugs (ARVs) patients is necessary.

摘要

背景

湖南省获得性耐药突变（ADR）的流行率数据很少，这可能会影响抗逆转录病毒治疗（ART）的效果。

目的

本研究的主要目的是确定湖南省接受过 ART 的失败的 HIV 患者中获得性耐药（ADR）的流行率以及 HIV-1 耐药株的流行特征。

方法

2012 年至 2017 年，对湖南省的 ART 经验丰富且病毒抑制失败的患者进行基因分型分析，并使用 HIVdb.stanford.edu 算法对突变进行评分，以推断药物敏感性。

结果

2012 年至 2017 年，HIV-1 ADR 的流行率分别为 2.76%、2.30%、2.98%、2.62%、2.23%和 2.17%。从 2932 名 ART 失败的患者中完成了 2295 个序列，其中 914 个序列发现有耐药突变。最常见的亚型是 AE（64.14%），其次是 BC（17.91%）和 B（11.50%）。在 914 名有耐药突变的患者中，93.11%有 NNRTI 相关的耐药突变，74.40%有 NRTI 耐药突变（DRMs），6.89%有 PI DRMs。591 例（64.66%）患者有双耐药突变，43 例（4.70%）患者有三耐药突变。NRTI、NNRTI 和 PI 相关耐药中最常见的耐药突变分别为 M184V（62.04%）、K103N（41.90%）和 I54L（3.83%）。93.76%有 DRMs 的患者接受了 ART 一线方案。CD4 计数、过去 3 个月的症状和 ART 依从性与 HIV-1 DR 有关。