2018年至2023年中国HIV传播耐药性的趋势与模式

Trends and Patterns of HIV Transmitted Drug Resistance in China From 2018 to 2023.

作者信息

Ye Jingrong, Dong Yuan, Lan Yun, Chen Jing, Zhou Ying, Liu Jinjin, Yuan Dan, Lu Xinli, Guo Weigui, Zheng Minna, Yang Hong, Song Xiao, Liu Cong, Zhou Quanhua, Zheng Chenli, Guo Qi, Yang Xiaohui, Zhang Lincai, Ge Zhangwen, Liu Lifeng, Yu Fengting, Han Yang, Huang Huihuang, Hao Mingqiang, Ruan Yuhua, Wu Jianjun, Li Jianjun, Chen Qiang, Ning Zhen, Ling Xuemei, Zhou Chang, Liu Xuangu, Bai Jianyun, Gao Ya, Tong Xue, Zhou Kangping, Mei Fanghua, Yang Zhengrong, Wang Ao, Wei Wei, Qiao Ruijuan, Luo Xinhua, Huang Xiaojie, Wang Juan, Shen Xin, Hu Fengyu, Zhang Linglin, Tan Wei, Fan Jixiang, Tu Aixia, Yu Guolong, Fang Yong, He Shufang, Chen Xin, Wu Donglin, Zhang Xinhui, Xin Ruolei, He Xin, Ren Xianlong, Xu Conghui, Sun Yanming, Li Yang, Liu Guowu, Li Xiyao, Duan Junyi, Huang Tao, Shao Yiming, Feng Yi, Pan Qichao, Su Bin, Jiang Tianjun, Zhao Hongxin, Zhang Tong, Chen Faqing, Hu Bing, Wang Hui, Zhao Jin, Cai Kun, Sun Wei, Gao Baicheng, Ning Tielin, Liang Shu, Huo Yuqi, Fu Gengfeng, Li Feng, Lin Yi, Xing Hui, Lu Hongyan

机构信息

Institute for HIV/AIDS and STD Prevention and Control, Beijing Center for Disease Prevention and Control (CDC), Beijing Academy of Preventive Medicine, Beijing.

Division of Tuberculosis and HIV/AIDS Prevention, Shanghai CDC, Shanghai.

出版信息

J Infect Dis. 2024 Dec 16;230(6):1410-1421. doi: 10.1093/infdis/jiae303.

DOI:10.1093/infdis/jiae303

PMID:39189826

Abstract

BACKGROUND

National treatment guidelines of China evolving necessitates population-level surveillance of transmitted drug resistance (TDR) to inform or update HIV treatment strategies.

METHODS

We analyzed the demographic, clinical, and virologic data obtained from people with HIV (PWH) residing in 31 provinces of China who were newly diagnosed between 2018 and 2023. Evidence of TDR was defined by the World Health Organization list for surveillance of drug resistance mutations.

RESULTS

Among the 22 124 PWH with protease and reverse transcriptase sequences, 965 (4.36%; 95% CI, 4.1-4.63) had at least 1 TDR mutation. The most frequent TDR mutations were nonnucleoside reverse transcriptase inhibitor (NNRTI) mutations (2.39%; 95% CI, 2.19%-2.59%), followed by nucleoside reverse transcriptase inhibitor mutations(1.35%; 95% CI, 1.2%-1.5%) and protease inhibitor mutations (1.12%; 95% CI, .98%-1.26%). The overall protease and reverse transcriptase TDR increased significantly from 4.05% (95% CI, 3.61%-4.52%) in 2018 to 5.39% (95% CI, 4.33%-6.57%) in 2023. A low level of integrase strand transfer inhibitor TDR was detected in 9 (0.21%; 95% CI, .1%-.38%) of 4205 PWH.

CONCLUSIONS

Presently, the continued use of NNRTI-based first-line antiretroviral therapy regimen for HIV treatment has been justified.

摘要

背景

中国国家治疗指南不断演变，因此有必要在人群层面监测传播性耐药（TDR），以为艾滋病治疗策略提供信息或进行更新。

方法

我们分析了2018年至2023年期间在中国31个省份新诊断的艾滋病毒感染者（PWH）的人口统计学、临床和病毒学数据。TDR的证据由世界卫生组织耐药突变监测清单定义。

结果

在22124例具有蛋白酶和逆转录酶序列的PWH中，965例（4.36%；95%CI，4.1 - 4.63）至少有1个TDR突变。最常见的TDR突变是非核苷类逆转录酶抑制剂（NNRTI）突变（2.39%；95%CI，2.19% - 2.59%），其次是核苷类逆转录酶抑制剂突变（1.35%；95%CI，1.2% - 1.5%）和蛋白酶抑制剂突变（1.ll%；95%CI，0.98% - 1.26%）。蛋白酶和逆转录酶的总体TDR从2018年的4.05%（95%CI，3.61% - 4.52%）显著增加到2023年的5.39%（95%CI，4.33% - 6.57%）。在4205例PWH中的9例（0.21%；95%CI，0.1% - 0.38%）中检测到低水平的整合酶链转移抑制剂TDR。