Guangzhou Medical Research Institute of Infectious Diseases, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China.
Infectious Disease Center, Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, China.
J Med Virol. 2024 Oct;96(10):e29937. doi: 10.1002/jmv.29937.
The presence of pretreatment drug resistance (PDR) is posing an increasing threat to HIV control. Here we investigated drug resistance mutations (DRMs) and PDR among 6831 HIV-infected individuals from 2018 to 2022 in Guangzhou, China. DRMs were detected among 24.5% of the patients. The overall prevalence of PDR was 7.4%, with resistance rate to nucleotide reverse transcriptase inhibitor (NRTI) being 1.3%, nonnucleoside reverse transcriptase inhibitor (NNRTI) 4.8%, and protease inhibitor (PI) 1.4%. Abacavir (0.8%) resistance was the most common in NRTI, followed by resistance to emtricitabine (0.6%), lamivudine (0.6%), and tenofovir disoproxil fumarate (0.3%). In NNRTI, nevirapine (3.7%) resistance was the most common, followed by efavirenz (3.5%) and rilpivirine (3.4%). Among PI, resistance to tipranavir (0.8%), nelfinavir (0.6%), fosamprenavir (0.2%) and lopinavir (0.1%) was most frequent. Annual prevalence of PDR showed an increase trend from 2018 to 2022, although not significant. In the multivariable logistic regression model, hepatitis B surface antigen positivity, circulating recombinant form (CRF) 55_01B, CRF08_BC, CRF59_01B, and subtype B were demonstrated as associated risk factors for PDR. The overall prevalence of PDR in Guangzhou was moderate, with relatively severe NNRTI resistance. Therefore, it remains crucial to continue monitoring PDR among newly diagnosed HIV-infected individuals.
治疗前耐药（PDR）的存在对 HIV 控制构成了越来越大的威胁。在这里，我们调查了 2018 年至 2022 年间来自中国广州的 6831 名 HIV 感染者的耐药突变（DRMs）和 PDR。24.5%的患者检测到 DRMs。PDR 的总体流行率为 7.4%，核苷酸逆转录酶抑制剂（NRTI）耐药率为 1.3%、非核苷类逆转录酶抑制剂（NNRTI）耐药率为 4.8%、蛋白酶抑制剂（PI）耐药率为 1.4%。NRTI 中最常见的耐药是阿巴卡韦（0.8%），其次是恩曲他滨（0.6%）、拉米夫定（0.6%）和替诺福韦二吡呋酯（0.3%）。在 NNRTI 中，奈韦拉平（3.7%）耐药最常见，其次是依非韦伦（3.5%）和利匹韦林（3.4%）。在 PI 中，最常见的耐药是替拉那韦（0.8%）、奈非那韦（0.6%）、福沙那韦（0.2%）和洛匹那韦（0.1%）。尽管不显著，但 PDR 的年流行率呈上升趋势，从 2018 年到 2022 年。在多变量逻辑回归模型中，乙型肝炎表面抗原阳性、循环重组形式（CRF）55_01B、CRF08_BC、CRF59_01B 和 B 亚型被证明是 PDR 的相关危险因素。广州的总体 PDR 流行率处于中等水平，NNRTI 耐药较为严重。因此，继续监测新诊断的 HIV 感染者的 PDR 仍然至关重要。
