Primary HIV Drug Resistance among Recently Infected Cases of HIV in North-West India
Primary HIV Drug Resistance among Recently Infected Cases of HIV in North-West India
复制标题
DOI：
10.1155/2019/1525646
复制
发表时间：
2019-01-01
影响因子：
1.7
通讯作者：
Kumar, R.
中科院分区：
文献类型：
--
作者：
Chauhan, C. K.;Lakshmi, P. V. M.;Kumar, R.
背景。抗逆转录病毒治疗可能会导致艾滋病毒耐药性的出现，这种耐药性是可以传播的。 HIV 原发性耐药 (PDR) 是一个重大的公共卫生问题，因为它有可能损害人群水平的抗逆转录病毒治疗 (ART) 的疗效。客观的。评估 2014 年 9 月至 2016 年 6 月印度西北部 6 个 ART 中心新近感染 HIV 病例的原发性耐药水平。方法。研究人员对 37 例最近感染的 HIV 病例的原发性耐药水平进行了研究，这些病例是通过基于改良的近期感染检测算法 (RITA) 的限制抗原 (Lag) 亲和力测定确定的。对 HIV-1 pol 基因的逆转录酶区域（1-268 个密码子）进行基因分型。使用斯坦福大学艾滋病毒耐药性（DR）数据库的校准群体耐药性（CPR）工具对序列进行分析，以识别耐药性。结果。在研究的 37 个分离株中，有 6 个（16.2%）样本对逆转录酶（RT）抑制剂表现出原发性耐药（PDR）。原发性耐药的比例在女性性工作者中为22.2%（2/9），在男男性行为者中为14.3%（1/7），在注射吸毒者中为14.3%（3/21）。观察到的突变为 K219R、L74V、K219N 和 Y181C。注射吸毒者 (IDU) 对核苷/核苷酸逆转录酶抑制剂 (NRTI) 或非核苷酸逆转录酶抑制剂 (NNRTI) 表现出耐药性。结论。最近，NRTI 或 NNRTI 的耐药性是一个需要解决的新挑战。两种 Y181C 分离株都是 IDU，这一事实很重要，并且代表 2/21（类似于 10%）的 NNRTI 耐药性。由于检测和治疗政策的引入，获得 ART 的机会不断增加，因此需要将原发性耐药性 (PDR) 监测纳入下一代 HIV 监测。
Background. Antiretroviral treatment may lead to the emergence of HIV drug resistance, which can be transmitted. HIV primary drug resistance (PDR) is of great public health concern because it has the potential to compromise the efficacy of antiretroviral therapy (ART) at the population level. Objective. To estimate the level of primary drug resistance among recently infected cases of HIV in 6 ART centres of North-Western India from September 2014 to June 2016. Methods. The level of primary drug resistance was studied among 37 recently infected HIV cases identified by Limiting antigen (Lag) avidity assay based on modified Recent Infection Testing Algorithm (RITA). The reverse transcriptase region of HIV-1 pol gene (1-268 codons) was genotyped. The sequences were analyzed using the Calibrated Population Resistance (CPR) tool of Stanford University HIV drug resistance (DR) database to identify drug resistance. Results. Among 37 isolates studied, 6 (16.2%) samples showed primary drug resistance (PDR) against reverse transcriptase (RT) inhibitor. The proportion of primary drug resistance was 22.2% (2/9) among female sex workers, 14.3% (1/7) among men having sex with men, and 14.3% (3/21) among injecting drug users. Observed mutations were K219R, L74V, K219N, and Y181C. Injecting drug user (IDU) has showed resistance to either nucleoside/nucleotide reverse transcriptase inhibitors (NRTI) or nonnucleotide reverse transcriptase inhibitors (NNRTI). Conclusion. Resistance to either NRTI or NNRTI among the recently is a new challenge that needs to be addressed. The fact that both Y181C isolates are IDUs is important and represents 2/21 (similar to 10%) NNRTI drug resistance. Surveillance for primary drug resistance (PDR) needs to be integrated into next generation of HIV surveillance as access to ART is increasing due to introduction of test and treat policy.