HIV-1 drug-resistant mutations and related risk factors among HIV-1-positive individuals experiencing treatment failure in Hebei Province, China.
HIV-1 drug-resistant mutations and related risk factors among HIV-1-positive individuals experiencing treatment failure in Hebei Province, China.
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HIV-1抗药性突变和相关危险因素在中国河北省患有治疗失败的HIV-1阳性个体中。
DOI：
10.1186/s12981-017-0133-3
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发表时间：
2017-01-23
影响因子：
2.2
通讯作者：
Chen S
中科院分区：
文献类型：
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作者：
Lu X;Zhao H;Zhang Y;Wang W;Zhao C;Li Y;Ma L;Cui Z;Chen S
为了解河北省11个地市HIV-1耐药情况，开展了HIV-1分子流行病学横断面调查。采集了中国河北省11个地市122例新诊断的drug-naïve hiv -1阳性个体和229例抗逆转录病毒治疗（ART）失败个体的血液样本。在采集血样时，采用标准化问卷，通过面对面访谈获得患者人口统计数据。HIV-1耐药（DR）基因分型采用内部检测。在本研究中，HIV-1 DR的总患病率为35.5%。HIV-1 DR在治疗失败参与者和ART-naïve参与者中的患病率分别为51.9和5.9%。蛋白酶抑制剂、核苷逆转录酶抑制剂（NRTIs）和非nrti （NNRTIs）的突变以及双重和多重突变在治疗失败的参与者中广泛存在。治疗失败组NNRTI突变比例（χ2 = 9.689, p = 0.002）和NNRTI双突变比例（χ2 = 39.958, p < 0.001）显著高于ART-naïve组。M184V/I和M41L突变在三种主要HIV-1基因型中的分布差异显著。病毒载量、近3个月症状、CD4计数、传播途径、抗逆转录病毒治疗持续时间与HIV-1 dr相关。结果提示，在抗逆转录病毒药物广泛应用的河北省，应根据HIV-1耐药株的流行特点制定新的防治策略。本文的在线版本（doi:10.1186/s12981-017-0133-3）包含补充材料，可供授权用户使用。
To understand HIV-1 drug resistance in 11 prefectures of Hebei Province, China, we implemented a cross-sectional HIV-1 molecular epidemiological survey. Blood samples were collected from 122 newly diagnosed drug-naïve HIV-1-positive individuals and 229 antiretroviral therapy (ART)-failure individuals from 11 prefectures in Hebei Province, China. Patient demographic data were obtained via face-to-face interviews using a standardized questionnaire when blood samples were collected. Genotyping of HIV-1 drug resistance (DR) was implemented using an in-house assay. In this study, the overall prevalence of HIV-1 DR was 35.5%. The prevalence of HIV-1 DR in participants experiencing treatment failure and ART-naïve participants was 51.9 and 5.9%, respectively. Mutations in protease inhibitors, nucleoside reverse transcriptase inhibitors (NRTIs), and non-NRTI (NNRTIs), as well as dual and multiple mutations were extensively seen in participants experiencing treatment failure. The proportions of NNRTI mutations (χ2 = 9.689, p = 0.002) and dual mutations in NRTIs and NNRTIs (χ2 = 39.958, p < 0.001) in participants experiencing treatment failure were significantly higher than those in ART-naïve participants. The distributions of M184V/I and M41L mutations differed significantly among three main HIV-1 genotypes identified. Viral load, symptoms in the past 3 months, CD4 counts, transmission route, and the duration of ART were found to be associated with HIV-1 DR. Our results suggest that new prevention and control strategies should be formulated according to the epidemic characteristics of HIV-1-resistant strains in Hebei Province, where antiretroviral drugs are widely used. The online version of this article (doi:10.1186/s12981-017-0133-3) contains supplementary material, which is available to authorized users.