Zhang Fei, Liang Bingyu, Liang Xu, Lin Zhaosen, Yang Yuan, Liang Na, Yang Yao, Liang Huayue, Jiang Jiaxiao, Huang Jiegang, Huang Rongye, Zhong Shanmei, Qin Cai, Jiang Junjun, Ye Li, Liang Hao
Guangxi Key Laboratory of AIDS Prevention and Treatment, School of Public Health, Guangxi Medical University, Nanning, China.
Guangxi Collaborative Innovation Center for Biomedicine, Life Science Institute, Guangxi Medical University, Nanning, China.
Front Genet. 2021 Sep 10;12:688292. doi: 10.3389/fgene.2021.688292. eCollection 2021.
Pretreatment drug resistance (PDR) is becoming an obstacle to the success of ART. This study investigated the prevalence of PDR and the transmission clusters (TCs) of drug resistance mutations (DRMs) in two cities where drug abuse used to be high to describe the local HIV-1 transmission dynamics.
Plasma samples were obtained from 1,027 ART-naïve patients in Guangxi. Viral subtypes and DRMs were identified. Transmission network and related factors were also determined.
A total of 1,025 eligible sequences were obtained from Qinzhou (65.8%) and Baise (34.2%) cities. The predominant HIV-1 genotype was CRF08_BC (45.0%), followed by CRF01_AE (40.9%). The overall prevalence of PDR was 8.3%, and resistance to NNRTI was the most common. Putative links with at least one other sequence were found in 543/1,025 (53.0%) sequences, forming 111 clusters (2-143 individuals). The most prevalent shared DRMs included V106I (45.35%), V179D (15.1%), and V179E (15.1%). Clusters related to shared DRMs were more frequent and larger in CRF08_BC. The prevalence of shared DRMs increased with time, while the proportion of PDR gradually decreased. Age > 50 years was associated with clustering. Subtype CRF08_BC was more likely to have DRMs, PDR propagation, and DRM sharing.
PDR prevalence is moderate in this region. The association between PDR and subtype CRF08_BC suggested that DRMs spreading from injection drug users (IDUs) to heterosexuals (HETs) might be the major source of PDR in this region. Our findings highlight the significance of continuous surveillance of PDR.
治疗前耐药（PDR）正成为抗逆转录病毒治疗（ART）成功的障碍。本研究调查了两个曾经药物滥用率较高的城市中PDR的流行情况以及耐药突变（DRM）的传播簇（TC），以描述当地HIV-1的传播动态。
从广西1027例未接受过ART治疗的患者中获取血浆样本。鉴定病毒亚型和DRM。还确定了传播网络及相关因素。
共从钦州（65.8%）和百色（34.2%）两市获得1025条合格序列。主要的HIV-1基因型为CRF08_BC（45.0%），其次是CRF01_AE（40.9%）。PDR的总体流行率为8.3% 耐药性，对非核苷类逆转录酶抑制剂（NNRTI）的耐药最为常见。在543/1025（53.0%）条序列中发现了与至少一条其他序列存在的推定联系，形成了111个簇（2 - 143人）。最常见的共享DRM包括V106I（45.35%）、V179D（15.1%）和V179E（15.1%）。与共享DRM相关的簇在CRF08_BC中更频繁且更大。共享DRM的流行率随时间增加，而PDR的比例逐渐下降。年龄>50岁与聚类有关。CRF08_BC亚型更有可能出现DRM、PDR传播和DRM共享。
该地区PDR流行率处于中等水平。PDR与CRF08_BC亚型之间的关联表明，从注射吸毒者（IDU）传播到异性恋者（HET）的DRM可能是该地区PDR的主要来源。我们的研究结果凸显了持续监测PDR的重要性。
