Objective To understand drug resistance prevalence among treatment-failure and treatment-nave HIV-positive individuals in China.Methods We searched five electronic databases（Wanfang,CNKI,CQVIP,SinoMed,and Pubmed） fo...Objective To understand drug resistance prevalence among treatment-failure and treatment-nave HIV-positive individuals in China.Methods We searched five electronic databases（Wanfang,CNKI,CQVIP,SinoMed,and Pubmed） for studies of HIV drug resistance.Random-effects models were carried out to estimate the prevalence of drug resistance among treatment-failure and treatment-nave individuals,respectively.Results The estimated nationwide rates of HIV drug resistance to any-class drugs among treatment-failure and treatment-nave individuals were 57%（95% CI：49%-65%） and 3.23%（95% CI：2.47%-4.07%）,respectively.Among the drug classes,the prevalence of resistance to PIs was low（1.45%;95% CI：0.73%-2.33%） in treatment-failure individuals,although high rates of resistance to NNRTIs（54%;95% CI：45%-63%） and NRTIs（40%;95% CI：32%-49%） were found.Resistance to any-class drugs,NNRTIs and NRTIs manifested regional differences,but resistance to PIs did not.Positive correlations were observed between resistance to NNRTIs and NRTIs among treatment-failure and treatment-nave individuals,respectively.Conclusion The prevalence of HIV drug resistance to NNRTIs and NRTIs among treatment-failure individuals was high.In contrast,the prevalence of drug resistance among treatment-nave individuals was low.The epidemics of drug resistance matched current treatment strategies and interventions in China.Surveillance for HIV drug resistance is necessary to assess the sustainability and durability of current treatment regimens.展开更多
Little is known about the prevalence of drug-resistant mutations in HIV-1-positive individuals in Suzhou, China. To elucidate the transmitted drug resistance(TDR) and acquired drug resistance mutation(ADR) profiles, w...Little is known about the prevalence of drug-resistant mutations in HIV-1-positive individuals in Suzhou, China. To elucidate the transmitted drug resistance(TDR) and acquired drug resistance mutation(ADR) profiles, we collected blood specimens from 127 drug-naive and 117 first-line drugtreated HIV-1-infected individuals sampled from 2014 to 2016 in Suzhou. We successfully amplified po/fragments from 100 drug-naive and 20 drug-treated samples. We then determined the drugresistant mutations to protease(PR) and reverse-transcriptase(RT) inhibitors according to the Stanford drug resistance database. Overall, 11 and 13 individuals had transmitted(drug-naive group) and acquired(treated group) resistance mutations, respectively. Six transmitted drugresistant mutations were found, including two mutations(L33F and L76V) in the protease region and four(K70N/E and V179D/E) in the RT region. Only L76 V was a major mutation, and K70N/E and V179D/E are known to cause low-level resistance to RT inhibitors. All 13 treated participants who had major drug resistance mutations demonstrated intermediate to high resistance to efavirenz and nevirapine, and six had a treatment duration of less than three months. No major mutations to RT inhibitors were found, implying that the epidemic of transmitted resistance mutations was not significant in this area. Our results suggest that more frequent virus load and drug resistance mutation tests should be conducted for individuals receiving antiretroviral treatment, especially for newly treated patients. Our research provides insights into the occurrence of HIV-1 drug resistance in Suzhou and will help to optimize the treatment strategy for this population.展开更多
高效逆转录病毒治疗(highly active antiretroviral treatment, HAART)自2003年推广以来,有效降低了HIV感染相关疾病的发病率和死亡率,延长了HIV感染者寿命,同时也促进了HIV耐药突变和耐药株的发生[1,2]。国内关于新报告HIV感染者原发...高效逆转录病毒治疗(highly active antiretroviral treatment, HAART)自2003年推广以来,有效降低了HIV感染相关疾病的发病率和死亡率,延长了HIV感染者寿命,同时也促进了HIV耐药突变和耐药株的发生[1,2]。国内关于新报告HIV感染者原发性耐药的研究较少,所报道的耐药率为1.6%~12.2% [3,4,5,6,7]。云南德宏傣族景颇族自治州(德宏州)地处西南边疆,与缅甸接壤,是国家HIV防治重点地区[8]。了解德宏州新报告HIV感染者原发性耐药情况,可指导抗病毒治疗,有效预防继发性耐药发生。为此,本研究对德宏州2016年新报告HIV感染者进行了原发性耐药研究。展开更多
基金supported by the National Megaprojects of Science Research for the 12th Five-Year Plan(2012ZX10001-001)
文摘Objective To understand drug resistance prevalence among treatment-failure and treatment-nave HIV-positive individuals in China.Methods We searched five electronic databases（Wanfang,CNKI,CQVIP,SinoMed,and Pubmed） for studies of HIV drug resistance.Random-effects models were carried out to estimate the prevalence of drug resistance among treatment-failure and treatment-nave individuals,respectively.Results The estimated nationwide rates of HIV drug resistance to any-class drugs among treatment-failure and treatment-nave individuals were 57%（95% CI：49%-65%） and 3.23%（95% CI：2.47%-4.07%）,respectively.Among the drug classes,the prevalence of resistance to PIs was low（1.45%;95% CI：0.73%-2.33%） in treatment-failure individuals,although high rates of resistance to NNRTIs（54%;95% CI：45%-63%） and NRTIs（40%;95% CI：32%-49%） were found.Resistance to any-class drugs,NNRTIs and NRTIs manifested regional differences,but resistance to PIs did not.Positive correlations were observed between resistance to NNRTIs and NRTIs among treatment-failure and treatment-nave individuals,respectively.Conclusion The prevalence of HIV drug resistance to NNRTIs and NRTIs among treatment-failure individuals was high.In contrast,the prevalence of drug resistance among treatment-nave individuals was low.The epidemics of drug resistance matched current treatment strategies and interventions in China.Surveillance for HIV drug resistance is necessary to assess the sustainability and durability of current treatment regimens.
基金supported by grants from the Natural Science Foundation of Jiangsu Province (BL2013017)the Suzhou Science and Technology Bureau (SYS201156) to Dr. Feng Qian+1 种基金the Suzhou Health and Family Planning Commission (LCZX201413) to Ming Lithe Key National Science and Technology Program in the Thirteen Five-Year Plan Period of China (2017ZX10201102-007-002)
文摘Little is known about the prevalence of drug-resistant mutations in HIV-1-positive individuals in Suzhou, China. To elucidate the transmitted drug resistance(TDR) and acquired drug resistance mutation(ADR) profiles, we collected blood specimens from 127 drug-naive and 117 first-line drugtreated HIV-1-infected individuals sampled from 2014 to 2016 in Suzhou. We successfully amplified po/fragments from 100 drug-naive and 20 drug-treated samples. We then determined the drugresistant mutations to protease(PR) and reverse-transcriptase(RT) inhibitors according to the Stanford drug resistance database. Overall, 11 and 13 individuals had transmitted(drug-naive group) and acquired(treated group) resistance mutations, respectively. Six transmitted drugresistant mutations were found, including two mutations(L33F and L76V) in the protease region and four(K70N/E and V179D/E) in the RT region. Only L76 V was a major mutation, and K70N/E and V179D/E are known to cause low-level resistance to RT inhibitors. All 13 treated participants who had major drug resistance mutations demonstrated intermediate to high resistance to efavirenz and nevirapine, and six had a treatment duration of less than three months. No major mutations to RT inhibitors were found, implying that the epidemic of transmitted resistance mutations was not significant in this area. Our results suggest that more frequent virus load and drug resistance mutation tests should be conducted for individuals receiving antiretroviral treatment, especially for newly treated patients. Our research provides insights into the occurrence of HIV-1 drug resistance in Suzhou and will help to optimize the treatment strategy for this population.
