Infectious Disease Institute of Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, Guangdong, China.
Institute of AIDS/STD Prevention and Control, Beijing Center for Disease Prevention and Control, Beijing, China.
J Antimicrob Chemother. 2020 Jul 1;75(7):1925-1931. doi: 10.1093/jac/dkaa116.
HIV-1 acquired drug resistance (ADR) has become a critical clinical and public health issue. Recently, HIV-1 CRF55_01B has been found more frequently in the MSM population.
To investigate the characteristics of HIV-1 drug resistance mutations (DRMs) and the extent of changes in drug susceptibility among ART-experienced CRF55_01B-infected adults of Guangdong.
ADR was tested for immediately in CRF55_01B-infected patients with virological failure. Demographic and epidemiological information was collected. DRMs and antiretroviral susceptibility were interpreted using the Stanford University HIV Drug Resistance Database HIVdb program.
Overall, 162 (4.78%) CRF55_01B isolates were identified from 2013 to 2018. Among DRMs, M184V (43.83%) was the most frequent NRTI DRM, followed by K65R (23.46%), and V179E (98.77%) was the most frequent NNRTI DRM, followed by K103N (47.53%) and Y181C (14.81%). According to the HIVdb program, 79.01% of the CRF55_01B-infected patients carried mutations conferring low-level or higher drug resistance to any of the three classes of ART drugs. Among PI DRMs, only one mutation affording low-level resistance to nelfinavir was found (0.62%). Among NRTI DRMs, a high proportion of high-level resistance to lamivudine (58.64%) and emtricitabine (58.02%) was found. As regards NNRTIs, more than 75% of patients carried efavirenz and nevirapine DRMs. The percentages of high-level resistance were 70.99%, 63.58%, 22.22%, 17.90% and 4.32% for nevirapine, efavirenz, rilpivirine, doravirine and etravirine, respectively.
High frequencies of DRMs and resistance were observed among CRF55_01B-infected patients failing ART in Guangdong, and interventions may be considered to minimize ecological contributions to ART.
HIV-1 获得性耐药（ADR）已成为一个重要的临床和公共卫生问题。最近，在男男性行为者（MSM）人群中发现 HIV-1 CRF55_01B 更为常见。
调查广东地区经 ART 治疗的 CRF55_01B 感染成人中 HIV-1 耐药突变（DRMs）的特征以及药物敏感性变化程度。
对发生病毒学失败的 CRF55_01B 感染患者进行即时 ADR 检测。收集人口统计学和流行病学信息。使用斯坦福大学 HIV 耐药数据库（HIVdb）程序解释 DRMs 和抗逆转录病毒药物敏感性。
2013 年至 2018 年期间，共发现 162 例（4.78%）CRF55_01B 分离株。在 DRMs 中，最常见的 NRTI 耐药突变是 M184V（43.83%），其次是 K65R（23.46%），最常见的 NNRTI 耐药突变是 V179E（98.77%），其次是 K103N（47.53%）和 Y181C（14.81%）。根据 HIVdb 程序，79.01%的 CRF55_01B 感染患者携带对三种 ART 药物中的任何一种均具有低水平或高水平耐药性的突变。在 PI DRMs 中，仅发现一种对奈韦拉平具有低水平耐药性的突变（0.62%）。在 NRTI DRMs 中，发现拉米夫定（58.64%）和恩曲他滨（58.02%）高水平耐药的比例较高。至于 NNRTIs，超过 75%的患者携带依非韦伦和奈韦拉平耐药突变。高水平耐药的比例分别为奈韦拉平 70.99%、依非韦伦 63.58%、rilpivirine 22.22%、doravirine 17.90%和 etravirine 4.32%。
在广东，经 ART 治疗失败的 CRF55_01B 感染患者中观察到 DRMs 和耐药率较高，可能需要采取干预措施以尽量减少对 ART 的生态贡献。
