Department of Infectious Diseases, Tianjin Second People's Hospital, Tianjin, 300192, People's Republic of China.
Tianjin Association of STD/AIDS Prevention and Control, Tianjin, 300011, People's Republic of China.
Drug Des Devel Ther. 2023 May 17;17:1485-1494. doi: 10.2147/DDDT.S406255. eCollection 2023.
The genetic diversity and genetic predisposition for drug resistance mutations are the primary features of human immunodeficiency virus type 1 (HIV-1), which could cause the incidence of failure of antiretroviral therapy (ART). This study investigates the distribution of various HIV-1 genotypes and the incidence of pretreatment drug resistance (PDR) in the antiretroviral-naive HIV-1 infected participants in Xi'an, China.
In this study, a cross-sectional analysis was carried out at the Xi'an Eighth Hospital between January 2020 and December 2021 among newly-diagnosed ART-naive HIV-1 infected participants. A nested PCR technique was used for amplifying the target segment of 1.3 kb present in the gene that spanned the reverse transcriptase and the protease regions. HIV-1 genotypes and the PDR-associated mutations were identified using the Stanford HIV Drug Resistance Database.
A total of 317 gene sequences were retrieved, amplified, and sequenced. The circulating recombinant form (CRF), CRF07_BC (51.7%) was seen to be the most prevalent HIV-1 genotype, followed by other genotypes like CRF01_AE (25.9%), B (14.2%), and CRF55_01B (4.7%). PDR was found in 18.3% of the population. The PDR mutation frequency in the non-nucleoside reverse transcriptase inhibitor (NNRTI) (16.1%) was significantly higher compared to that of the nucleoside reverse transcriptase inhibitor (NRTI) (4.4%) and the protease inhibitor (0.9%). V179D/E (both were 4.4%) was seen to be the most predominant type of NNRTI mutation. K65R and M184V (1.3%) were the most frequent NRTI-associated mutations. About half (48.3%) of the sequenced HIV-1 strains that had mutations could show a potential low-level NNRTI resistance owing to V179D/E. Multivariate regression analysis revealed one PDR mutation associated with subtype CRF01_AE (p=0.002) and CRF55_01B (p<0.001) as a higher risk mutation.
Diverse and complex HIV-1 genotypes are distributed in Xi'an, China. Considering new evidence, it is necessary to screen for baseline HIV-1 drug resistance among the newly-diagnosed HIV-1 individuals.
人类免疫缺陷病毒 1 型（HIV-1）的主要特征是遗传多样性和耐药突变的遗传倾向，这可能导致抗逆转录病毒治疗（ART）失败的发生率。本研究调查了中国西安新诊断的未经抗逆转录病毒治疗（ART）的 HIV-1 感染者中各种 HIV-1 基因型的分布和治疗前耐药（PDR）的发生率。
本研究于 2020 年 1 月至 2021 年 12 月在西安第八医院对新诊断的未经 ART 治疗的 HIV-1 感染者进行了一项横断面分析。采用巢式 PCR 技术扩增基因中跨越逆转录酶和蛋白酶区域的 1.3kb 靶片段。使用斯坦福 HIV 耐药数据库确定 HIV-1 基因型和与耐药相关的突变。
共获得 317 个基因序列，进行了扩增和测序。循环重组形式（CRF）CRF07_BC（51.7%）是最常见的 HIV-1 基因型，其次是其他基因型，如 CRF01_AE（25.9%）、B（14.2%）和 CRF55_01B（4.7%）。人群中发现 18.3%存在 PDR。非核苷类逆转录酶抑制剂（NNRTI）的 PDR 突变频率（16.1%）明显高于核苷类逆转录酶抑制剂（NRTI）（4.4%）和蛋白酶抑制剂（0.9%）。V179D/E（均为 4.4%）是最常见的 NNRTI 突变类型。K65R 和 M184V（各 1.3%）是最常见的 NRTI 相关突变。由于 V179D/E，约一半（48.3%）具有突变的测序 HIV-1 株可能表现出潜在的低水平 NNRTI 耐药性。多变量回归分析显示，与亚型 CRF01_AE（p=0.002）和 CRF55_01B（p<0.001）相关的一个 PDR 突变是更高风险的突变。
中国西安分布着多种复杂的 HIV-1 基因型。考虑到新证据，有必要对新诊断的 HIV-1 个体进行基线 HIV-1 耐药性筛查。
