Pang Xianwu, Liang Shujia, Tang Kailing, Huang Jinghua, He Qin, Fang Ningye, Xie Bo, Xie Xing, Wang Huifeng, Hu Yanling, Lan Guanghua
Guangxi Key Laboratory of Major Infectious Disease Prevention Control and Biosafety Emergency Response, Guangxi Key Laboratory of AIDS Prevention Control and Translation, Guangxi Center for Disease Control and Prevention, Nanning, Guangxi, China.
Collaborative Innovation Centre of Regenerative Medicine and Medical BioResource Development and Application Co-constructed by the Province and Ministry, Guangxi Medical University, Nanning, Guangxi, China.
Open Forum Infect Dis. 2023 Jan 16;10(2):ofad016. doi: 10.1093/ofid/ofad016. eCollection 2023 Feb.
The prevalence of human immunodeficiency type 1 (HIV-1) pretreatment drug resistance (PDR) in men who have sex with men (MSM) in Guangxi remains unclear, and its effect on antiretroviral therapy (ART) needs to be further studied.
Individuals newly diagnosed with HIV in Guangxi from 2016 to 2020, which mainly included MSM and the heterosexual (HES) population, were recruited in this study. Pol sequences were sequenced to analyze PDR and construct a genetic network. The risk factors for PDR and the effect on ART were respectively analyzed.
The PDR of MSM in Guangxi was 4.7% (34/716), consisting of nonnucleoside reverse transcriptase inhibitors (3.5%), protease inhibitors (0.8%), integrase strand transfer inhibitors (0.7%), and nucleoside reverse transcriptase inhibitors (0.4%), and lower than that of HES (9.3% [77/827]). The subtype was associated with PDR, and MSM was lower than HES (CRF01_AE: 3.0% vs 8.0%; CRF07_BC: 4.1% vs 7.2%). CRF55_01B (adjusted odds ratio [aOR], 3.35) was a risk factor for PDR in MSM, while CRF08_BC (aOR, 2.34) and older (aOR, 2.75) were risk factors for PDR in HES. Six of 18 (33.3%) PDR of MSM in the network connected to each other, lower than that of HES (61.1% [22/36]). CRF55_01B (aOR, 5.69) was a risk factor for PDR transmission in MSM, while CRF08_BC (aOR, 4.08) was a risk factor in HES. Pretreatment CD4 T-cell count, age, infection route, and subtype were associated with recovery of CD4 count and suppression of viral load.
The prevalence of PDR was different between MSM and HES, which may be associated with subtype. Thus, the monitoring of subtype and PDR should be strengthened.
广西男男性行为者（MSM）中人类免疫缺陷病毒1型（HIV-1）治疗前耐药（PDR）的流行情况尚不清楚，其对抗逆转录病毒治疗（ART）的影响有待进一步研究。
本研究招募了2016年至2020年在广西新诊断出感染HIV的个体，主要包括男男性行为者和异性恋者。对多聚酶（Pol）序列进行测序以分析治疗前耐药情况并构建遗传网络。分别分析治疗前耐药的危险因素及其对ART的影响。
广西男男性行为者的治疗前耐药率为4.7%（34/716），包括非核苷类逆转录酶抑制剂耐药（3.5%）、蛋白酶抑制剂耐药（0.8%）、整合酶链转移抑制剂耐药（0.7%）和核苷类逆转录酶抑制剂耐药（0.4%），低于异性恋者（9.3%[77/827]）。亚型与治疗前耐药有关，男男性行为者低于异性恋者（CRF01_AE：3.0%对8.0%；CRF07_BC：4.1%对7.2%）。CRF55_01B（调整优势比[aOR]，3.35）是男男性行为者治疗前耐药的危险因素，而CRF08_BC（aOR，2.34）和年龄较大（aOR，2.75）是异性恋者治疗前耐药的危险因素。男男性行为者中18例治疗前耐药者中有6例（33.3%）在网络中相互关联，低于异性恋者（61.1%[22/36]）。CRF55_01B（aOR，5.69）是男男性行为者治疗前耐药传播的危险因素，而CRF08_BC（aOR，4.08）是异性恋者中的危险因素。治疗前CD4 T细胞计数、年龄、感染途径和亚型与CD4计数恢复及病毒载量抑制有关。
男男性行为者和异性恋者的治疗前耐药流行情况不同，这可能与亚型有关。因此，应加强对亚型和治疗前耐药的监测。
