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Zhang J, Sun B, Sheng Z, Ding X, Fan Q, Huang G, Guo Z, Zhong P, Liao L, Xing H, Xia Y, Chai C, Jiang J. Full-Spectrum Surveillance of Pre-Treatment HIV Drug Resistance in Southeastern China. Pharmaceuticals (Basel) 2024; 17:900. [PMID: 39065750 PMCID: PMC11279794 DOI: 10.3390/ph17070900] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2024] [Revised: 06/30/2024] [Accepted: 07/03/2024] [Indexed: 07/28/2024] Open
Abstract
HIV drug resistance compromises the ability of anti-retroviral therapy (ART) to suppress viral replication, resulting in treatment failure. This study investigates the prevalence of pre-treatment drug resistance (PDR) in newly diagnosed individuals in a prosperous city (Wenzhou) in Southeastern China. A cross-sectional investigation was carried out among 473 newly diagnosed ART-naive HIV-1-infected individuals between January and December 2022. The protease-reverse transcriptase (PR-RT) region and integrase (IN) region of HIV-1 were amplified by two separately nested PCRs, followed by sequencing. Drug resistance mutations (DRMs) and drug resistance to nucleoside reverse transcriptase inhibitors (NRTIs), non-nucleoside reverse transcriptase inhibitors (NNRTIs), protease inhibitors (PIs) and integrase strand transfer inhibitors (INSTIs) were analyzed. The PDR prevalence was 6.5% [95% CI: 4.4-9.1] for any anti-retroviral drug, 0.9% [95% CI: 0.3-2.3] for NRTIs, 4.1% [95% CI: 2.5-6.5] for NNRTIs, 1.8% [95% CI: 0.8-3.6] for PIs and 0.5% [95% CI: 0.1-1.8] for INSTIs. According to the subtyping results of the PR-RT region, 11 different subtypes and 31 unique recombinant forms (URFs) were found. CRF07_BC was the dominant subtype (53.7%, 233/434), followed by CRF01_AE (25.3%, 110/434). V179D (1.6%) and K103N (1.4%) were the most predominant types of NNRTI DRMs. Q58E (1.2%) and M184V (0.7%) were the most frequent PI DRMs and NRTI DRMs, respectively. The INSTI-related DRMs Y143S (causes high-level resistance to RAL) and G163K (causes low-level resistance to EVG and RAL) were found in one patient each. Given the relatively high PDR prevalence of NNRTI (4.1%), non-NNRTI-based ART may be preferred in the future. It is recommended to include genotypic resistance testing before starting ART in regions where feasible.
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Affiliation(s)
- Jiafeng Zhang
- Department of HIV/AIDS Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China; (J.Z.); (X.D.); (Q.F.); (G.H.); (Z.G.); (Y.X.)
| | - Baochang Sun
- Department of Microbiological Test, Wenzhou Municipal Center for Disease Control and Prevention, Wenzhou 325001, China;
| | - Zihang Sheng
- School of Laboratory Medicine and School of Life Sciences, Wenzhou Medical University, Wenzhou 325035, China;
| | - Xiaobei Ding
- Department of HIV/AIDS Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China; (J.Z.); (X.D.); (Q.F.); (G.H.); (Z.G.); (Y.X.)
| | - Qin Fan
- Department of HIV/AIDS Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China; (J.Z.); (X.D.); (Q.F.); (G.H.); (Z.G.); (Y.X.)
| | - Gang Huang
- Department of HIV/AIDS Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China; (J.Z.); (X.D.); (Q.F.); (G.H.); (Z.G.); (Y.X.)
- Health Science Center, Ningbo University, Ningbo 315211, China
| | - Zhihong Guo
- Department of HIV/AIDS Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China; (J.Z.); (X.D.); (Q.F.); (G.H.); (Z.G.); (Y.X.)
| | - Ping Zhong
- Shanghai Municipal Center for Diseases Control and Prevention, Shanghai 200336, China;
| | - Lingjie Liao
- Division of Virology and Immunology, National Center for AIDS/STD Control and Prevention (NCAIDS), Beijing 102206, China; (L.L.); (H.X.)
| | - Hui Xing
- Division of Virology and Immunology, National Center for AIDS/STD Control and Prevention (NCAIDS), Beijing 102206, China; (L.L.); (H.X.)
| | - Yan Xia
- Department of HIV/AIDS Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China; (J.Z.); (X.D.); (Q.F.); (G.H.); (Z.G.); (Y.X.)
| | - Chengliang Chai
- Department of HIV/AIDS Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China; (J.Z.); (X.D.); (Q.F.); (G.H.); (Z.G.); (Y.X.)
| | - Jianmin Jiang
- Department of HIV/AIDS Control and Prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China; (J.Z.); (X.D.); (Q.F.); (G.H.); (Z.G.); (Y.X.)
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Shi YZ, Huang HH, Wang XH, Song B, Jiang TJ, Yu MR, Wang ZR, Li RT, Jiao YM, Su X, Wang FS. Retrospective Study on Genetic Diversity and Drug Resistance among People Living with HIV at an AIDS Clinic in Beijing. Pharmaceuticals (Basel) 2024; 17:115. [PMID: 38256948 PMCID: PMC10819489 DOI: 10.3390/ph17010115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 01/03/2024] [Accepted: 01/10/2024] [Indexed: 01/24/2024] Open
Abstract
(1) Background: The objective of this study was to investigate the prevalence of genetic diversity and drug resistance mutations among people living with HIV (PLWH) attending clinics in Beijing. (2) Methods: A retrospective analysis was conducted on PLWH admitted to the Fifth Medical Center of People's Liberation Army (PLA) General Hospital between 1 March 2013 and 31 July 2020. The participants were analyzed for pretreatment drug resistance (PDR) and acquired drug resistance (ADR). Nested polymerase chain reaction (PCR) was utilized to amplify the pol gene from plasma RNA samples obtained from the participants. Genotypic and HIV drug resistance were determined using the Stanford University HIV Drug Resistance Database. Univariate and multifactorial logistic analyses were used to assess the risk factors for PDR. (3) Results: The overall prevalence rates of PDR and ADR were 12.9% and 27.8%, respectively. Individuals treated with non-nucleoside reverse transcriptase inhibitors (NNRTIs) exhibited the highest prevalence of mutations. Specific mutation sites, such as V179D for NNRTIs and M184V and K65R for nucleoside reverse transcriptase inhibitors (NRTIs), were identified as prevalent mutations. Individuals treated with efavirenz (EFV) and nevirapine (NVP) were found to be susceptible to developing resistance. The multifactorial regression analyses indicated that the factors of circulating recombination form (CRF) genotype CRF07-BC and a high viral load were associated with an increased risk of PDR. CRF01-AE and CRF07-BC were the most prevalent HIV genotypes in our study. (4) Conclusions: The distribution of HIV genotypes in Beijing is complex. There is a need for baseline screening for HIV drug resistance among ART-naive individuals, as well as timely testing for drug resistance among ART-experienced individuals.
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Affiliation(s)
- Yan-Ze Shi
- Medical School of Chinese People’s Liberation Army (PLA), Beijing 100853, China; (Y.-Z.S.); (M.-R.Y.); (Z.-R.W.)
- Department of Infectious Diseases, The Fifth Medical Centre of Chinese PLA General Hospital, National Clinical Research Centre for Infectious Diseases, Beijing 100853, China; (H.-H.H.); (X.-H.W.); (T.-J.J.)
| | - Hui-Huang Huang
- Department of Infectious Diseases, The Fifth Medical Centre of Chinese PLA General Hospital, National Clinical Research Centre for Infectious Diseases, Beijing 100853, China; (H.-H.H.); (X.-H.W.); (T.-J.J.)
| | - Xin-Hua Wang
- Department of Infectious Diseases, The Fifth Medical Centre of Chinese PLA General Hospital, National Clinical Research Centre for Infectious Diseases, Beijing 100853, China; (H.-H.H.); (X.-H.W.); (T.-J.J.)
| | - Bing Song
- Department of Infectious Diseases, The Fifth Medical Centre of Chinese PLA General Hospital, National Clinical Research Centre for Infectious Diseases, Beijing 100853, China; (H.-H.H.); (X.-H.W.); (T.-J.J.)
| | - Tian-Jun Jiang
- Department of Infectious Diseases, The Fifth Medical Centre of Chinese PLA General Hospital, National Clinical Research Centre for Infectious Diseases, Beijing 100853, China; (H.-H.H.); (X.-H.W.); (T.-J.J.)
| | - Min-Rui Yu
- Medical School of Chinese People’s Liberation Army (PLA), Beijing 100853, China; (Y.-Z.S.); (M.-R.Y.); (Z.-R.W.)
- Department of Infectious Diseases, The Fifth Medical Centre of Chinese PLA General Hospital, National Clinical Research Centre for Infectious Diseases, Beijing 100853, China; (H.-H.H.); (X.-H.W.); (T.-J.J.)
| | - Ze-Rui Wang
- Medical School of Chinese People’s Liberation Army (PLA), Beijing 100853, China; (Y.-Z.S.); (M.-R.Y.); (Z.-R.W.)
- Department of Gastroenterology, First Medical Center of Chinese PLA General Hospital, Beijing 100036, China
| | - Rui-Ting Li
- State Key Laboratory of Pathogenand Biosecurity, Beijing Institute of Microbiology and Epidemiology, Academy of Military Medical Sciences (AMMS), Beijing 100850, China;
| | - Yan-Mei Jiao
- Department of Infectious Diseases, The Fifth Medical Centre of Chinese PLA General Hospital, National Clinical Research Centre for Infectious Diseases, Beijing 100853, China; (H.-H.H.); (X.-H.W.); (T.-J.J.)
| | - Xin Su
- Department of Infectious Diseases, The Fifth Medical Centre of Chinese PLA General Hospital, National Clinical Research Centre for Infectious Diseases, Beijing 100853, China; (H.-H.H.); (X.-H.W.); (T.-J.J.)
| | - Fu-Sheng Wang
- Medical School of Chinese People’s Liberation Army (PLA), Beijing 100853, China; (Y.-Z.S.); (M.-R.Y.); (Z.-R.W.)
- Department of Infectious Diseases, The Fifth Medical Centre of Chinese PLA General Hospital, National Clinical Research Centre for Infectious Diseases, Beijing 100853, China; (H.-H.H.); (X.-H.W.); (T.-J.J.)
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