Huang Dan-Dan, Liu Jun-Jie, Chen Ya-Ting, Yang Rong-Rong, Su Jun-Zhi, Gao Qian, Chen Xin
Department of Pathogenic Biology, School of Basic Medical Sciences, Gannan Medical University, No. 1 Hexie Avenue, Zhanggong District, Ganzhou, 341000, China.
Department of Laboratory, Ganzhou Center for Disease Control and Prevention, Ganzhou, 341000, China.
AIDS Res Ther. 2025 Jun 16;22(1):63. doi: 10.1186/s12981-025-00758-0.
Primary drug resistance (PDR) is an important cause of antiretroviral therapy (ART) failure. However, the prevalence and characteristics of PDR in Ganzhou remain unclear.
From July 2018 to August 2021, treatment-naïve, newly diagnosed HIV-infected individuals in Ganzhou, China were recruited. Blood samples were collected, and the HIV pol gene was amplified by nested PCR followed by Sanger sequencing. Sequence editing and assembly were performed using DNASTAR Lasergene software, and subsequent analysis for resistance mutations and drug susceptibility profiling was conducted using the Stanford University HIV Drug Resistance Database.
Among 108 successfully amplified samples, seven exhibited low-, intermediate-, or high-level resistance mutations, resulting in a PDR prevalence of 6.5%. Among them, the mutation rate of non-nucleoside reverse transcriptase inhibitors (NNRTIs) was 4.6%, and the drug resistance mutation rates of nucleoside reverse transcriptase inhibitors and integrase strand transfer inhibitors (INSTIs) were both 0.9%. No protease inhibitor resistance was detected. Nine drug resistance mutations were detected, among which six were related to NNRTIs, one was related to nucleoside reverse transcriptase inhibitors, and two were related to INSTIs. The K103N and Y181C mutations conferred intermediate-to-high resistance to NNRTIs, while A98G and V179E caused low-to-intermediate resistance to NNRTIs, and the remaining mutations led to low drug resistance to the respective drugs.
Compared to other regions in China, Ganzhou exhibits a relatively low PDR among newly diagnosed HIV-infected individuals. However, the emergence of INSTI-resistant strains underscores the need for enhanced resistance surveillance to prevent the spread of drug-resistant strains caused by ART failure.
原发性耐药（PDR）是抗逆转录病毒疗法（ART）失败的一个重要原因。然而，赣州地区原发性耐药的流行情况和特征仍不清楚。
2018年7月至2021年8月，招募了中国赣州地区初治、新诊断的HIV感染者。采集血样，通过巢式PCR扩增HIV pol基因，随后进行桑格测序。使用DNASTAR Lasergene软件进行序列编辑和组装，并使用斯坦福大学HIV耐药数据库对耐药突变和药物敏感性进行后续分析。
在108份成功扩增的样本中，7份呈现低、中、高水平的耐药突变，原发性耐药流行率为6.5%。其中，非核苷类逆转录酶抑制剂（NNRTIs）的突变率为4.6%，核苷类逆转录酶抑制剂和整合酶链转移抑制剂（INSTIs）的耐药突变率均为0.9%。未检测到蛋白酶抑制剂耐药。共检测到9种耐药突变，其中6种与NNRTIs相关，1种与核苷类逆转录酶抑制剂相关，2种与INSTIs相关。K103N和Y181C突变对NNRTIs产生中到高耐药性，而A98G和V179E对NNRTIs产生低到中耐药性，其余突变对相应药物产生低耐药性。
与中国其他地区相比，赣州地区新诊断的HIV感染者中原发性耐药率相对较低。然而，INSTI耐药菌株的出现凸显了加强耐药监测以防止ART失败导致耐药菌株传播的必要性。
