Graduate Collaborative Training Base of The First Hospital of Changsha, Hengyang Medical School, University of South China, Hengyang, China.
The Institute of HIV/AIDS, The First Hospital of Changsha, Hunan, China.
AIDS Res Hum Retroviruses. 2023 Aug;39(8):422-428. doi: 10.1089/AID.2022.0077. Epub 2023 Apr 10.
At present, research on the prevalence of primary drug resistance (PDR) in Hunan Province is limited. Therefore, we explored the current status of HIV-1 PDR in Hunan to provide a basis for antiretroviral therapy (ART) and a theoretical foundation for prevention and control of the HIV/AIDS epidemic. Three hundred seventy newly diagnosed HIV-1-infected individuals who had not received ART in Hunan province, China, were enrolled in the study. Plasma samples were collected, RNA was extracted, two rounds of gene amplification were carried out with the in-house method, and subtype analysis and drug resistance analysis were carried out with relevant software. We found that the most prevalent subtypes of HIV-1 in Hunan Province are CRF_01AE (126/359, 35.1%) and CRF07_BC (85/359, 23.7%). The PDR rate among newly diagnosed HIV/AIDS patients was 10.0% (36/359). Among them, the drug resistance rates of protease inhibitors, nucleotide reverse transcriptase inhibitors, non-nucleotide reverse transcriptase inhibitors, and integrase inhibitors were 0.3% (1/359), 3.3% (12/359), 8.36% (30/359), and 0.6% (2/359), respectively. The distribution of HIV-1 subtypes in Hunan Province is diverse and complex, and the PDR rate has exceeded the low-level warning line set by the World Health Organization (<5%). Therefore, we should conduct pretreatment drug resistance assays to determine the optimal primary ART so that patients can obtain better antiretroviral treatment outcomes and transmission of drug-resistant strains in the population can be blocked.
目前，湖南省原发性耐药（PDR）流行情况的研究较为有限。因此，我们旨在探讨湖南省 HIV-1 原发性耐药的流行现状，为抗反转录病毒治疗（ART）提供依据，并为艾滋病疫情的防控提供理论基础。本研究共纳入湖南省 370 例未经 ART 治疗的新诊断 HIV-1 感染者。采集血浆样本，提取 RNA，采用自建方法进行两轮基因扩增，运用相关软件进行亚型分析和耐药性分析。结果发现，湖南省 HIV-1 流行的主要亚型为 CRF_01AE（126/359，35.1%）和 CRF07_BC（85/359，23.7%）。新诊断 HIV/AIDS 患者的 PDR 率为 10.0%（36/359）。其中，蛋白酶抑制剂、核苷酸逆转录酶抑制剂、非核苷酸逆转录酶抑制剂和整合酶抑制剂的耐药率分别为 0.3%（1/359）、3.3%（12/359）、8.36%（30/359）和 0.6%（2/359）。湖南省 HIV-1 亚型分布多样且复杂，PDR 率已超过世界卫生组织（WHO）设定的<5%的低水平预警线。因此，我们应进行治疗前耐药检测，以确定最佳的一线 ART，使患者获得更好的抗病毒治疗效果，并阻断耐药株在人群中的传播。
