Department of Medicine, Stanford University, Stanford, CA 94305, USA.
Viruses. 2021 May 11;13(5):879. doi: 10.3390/v13050879.
In 2009, a list of nonpolymorphic HIV-1 drug resistance mutations (DRMs), called surveillance DRMs (SDRMs), was created to monitor transmitted drug resistance (TDR). Since 2009, TDR increased and antiretroviral therapy (ART) practices changed. We examined the changing prevalence of SDRMs and identified candidate SDRMs defined as nonpolymorphic DRMs present on ≥ 1 expert DRM list and in ≥0.1% of ART-experienced persons. Candidate DRMs were further characterized according to their association with antiretrovirals and changing prevalence. Among NRTI-SDRMs, tenofovir-associated mutations increased in prevalence while thymidine analog mutations decreased in prevalence. Among candidate NRTI-SDRMs, there were six tenofovir-associated mutations including three which increased in prevalence (K65N, T69deletion, K70G/N/Q/T). Among candidate NNRTI-SDRMs, six that increased in prevalence were associated with rilpivirine (E138K/Q, V179L, H221Y) or doravirine (F227C/L) resistance. With the notable exceptions of I47A and I50L, most PI-SDRMs decreased in prevalence. Three candidate PI-SDRMs were accessory darunavir-resistance mutations (L10F, T74P, L89V). Adding the candidate SDRMs listed above was estimated to increase NRTI, NNRTI, and PI TDR prevalence by 0.1%, 0.3%, and 0.3%, respectively. We describe trends in the prevalence of nonpolymorphic HIV-1 DRMs in ART-experienced persons. These data should be considered in decisions regarding SDRM list updates and TDR monitoring.
2009 年，为了监测传播性耐药（TDR），创建了一组非多态性 HIV-1 耐药突变（DRMs），称为监测性耐药突变（SDRMs）。自 2009 年以来，TDR 增加，抗逆转录病毒治疗（ART）实践发生了变化。我们检查了 SDRMs 不断变化的流行率，并确定了候选 SDRMs，这些 SDRMs 被定义为存在于≥1 个专家 DRM 列表中和≥0.1%的 ART 经验者中的非多态性 DRMs。候选 DRMs 根据其与抗逆转录病毒药物的关联和不断变化的流行率进一步进行了特征描述。在 NRTI-SDRMs 中，与替诺福韦相关的突变的流行率增加，而胸苷类似物突变的流行率下降。在候选 NRTI-SDRMs 中，有六个与替诺福韦相关的突变，包括三个流行率增加的突变（K65N、T69 缺失、K70G/N/Q/T）。在候选 NNRTI-SDRMs 中，六个与利匹韦林（E138K/Q、V179L、H221Y）或多拉韦林（F227C/L）耐药相关的突变的流行率增加。除了 I47A 和 I50L 外，大多数 PI-SDRMs 的流行率下降。三个候选 PI-SDRMs 是辅助达芦那韦耐药突变（L10F、T74P、L89V）。添加上述候选 SDRMs 估计将使 NRTI、NNRTI 和 PI TDR 的流行率分别增加 0.1%、0.3%和 0.3%。我们描述了在接受 ART 治疗的人群中非多态性 HIV-1 DRMs 流行率的趋势。在更新 SDRM 列表和监测 TDR 时，应考虑这些数据。
