HIV drug resistance in HIV positive individuals under antiretroviral treatment in Shandong Province, China

Lin, Bingliang; Sun, Xiaoguang; Su, Shengli; Lv, Cuixia; Zhang, Xiaofei; Lin, Lin; Wang, Rui; Fu, Jihua; Kang, Dianmin

doi:10.1371/journal.pone.0181997

Cited by 14 publications

(15 citation statements)

References 33 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…The most common NRTI and PI RAMs among those genotyped in our cohort are consistent with the RAMs identified in other studies from the region [22,27,38]. M184V, the predominant NRTI mutation found in our study, has been shown to confer high‐level resistance to lamivudine and emtricitabine [39].…”

Section: Discussionsupporting

confidence: 90%

Virological failure and HIV drug resistance among adults living with HIV on second‐line antiretroviral therapy in the Asia‐Pacific

Ross¹,

Jiamsakul

Kumarasamy

et al. 2020

HIV Medicine

View full text Add to dashboard Cite

Objectives To assess second‐line antiretroviral therapy (ART) virological failure and HIV drug resistance‐associated mutations (RAMs), in support of third‐line regimen planning in Asia. Methods Adults > 18 years of age on second‐line ART for ≥ 6 months were eligible. Cross‐sectional data on HIV viral load (VL) and genotypic resistance testing were collected or testing was conducted between July 2015 and May 2017 at 12 Asia‐Pacific sites. Virological failure (VF) was defined as VL > 1000 copies/mL with a second VL > 1000 copies/mL within 3–6 months. FASTA files were submitted to Stanford University HIV Drug Resistance Database and RAMs were compared against the IAS‐USA 2019 mutations list. VF risk factors were analysed using logistic regression. Results Of 1378 patients, 74% were male and 70% acquired HIV through heterosexual exposure. At second‐line switch, median [interquartile range (IQR)] age was 37 (32–42) years and median (IQR) CD4 count was 103 (43.5–229.5) cells/µL; 93% received regimens with boosted protease inhibitors (PIs). Median duration on second line was 3 years. Among 101 patients (7%) with VF, CD4 count > 200 cells/µL at switch [odds ratio (OR) = 0.36, 95% confidence interval (CI): 0.17–0.77 vs. CD4 ≤ 50) and HIV exposure through male–male sex (OR = 0.32, 95% CI: 0.17–0.64 vs. heterosexual) or injecting drug use (OR = 0.24, 95% CI: 0.12–0.49) were associated with reduced VF. Of 41 (41%) patients with resistance data, 80% had at least one RAM to nonnucleoside reverse transcriptase inhibitors (NNRTIs), 63% to NRTIs, and 35% to PIs. Of those with PI RAMs, 71% had two or more. Conclusions There were low proportions with VF and significant RAMs in our cohort, reflecting the durability of current second‐line regimens.

show abstract

Section: Discussionsupporting

confidence: 90%

Virological failure and HIV drug resistance among adults living with HIV on second‐line antiretroviral therapy in the Asia‐Pacific

Ross¹,

Jiamsakul

Kumarasamy

et al. 2020

HIV Medicine

View full text Add to dashboard Cite

show abstract

“…Nevertheless, most socioeconomic variables did not also show any significant association with the occurrence of resistant mutations in both ART-naïve and ART-experienced patients. However, in line with a study conducted in China [47], a lower level of education (≤ 7 years of school) was associated (p = 0.015) with resistance-associated mutations amongst ART-experienced patients. While low monthly income (≤ 50,000 XAF) was borderline associated (p = 0.072) with the occurrence of resistance mutations.…”

Section: Discussionsupporting

confidence: 80%

“…Tenofovir had the least resistance among patients on ART [45] and no resistance was reported among treatment-naïve patients probably due to fact that this drug was recently introduced in Cameroon in 2010, as a replacement to stavudine [46]. Resistance to lamivudine and emtricitabine were high in this study, yet lamivudine remains critical to recent innovative treatment strategies due to its efficacy, safety profile and the availability of low-cost generic versions [47].…”

Section: Discussionmentioning

confidence: 97%

Genetic diversity and antiretroviral resistance-associated mutation profile of treated and naive HIV-1 infected patients from the Northwest and Southwest regions of Cameroon

et al. 2019

View full text Add to dashboard Cite

BackgroundAntiretroviral therapy (ART) has improved the survival of HIV infected persons. However, rapid scale-up of ART and the high HIV-1 genetic variability, has greatly influenced the emergence of drug-resistant strains. This constitutes a potential threat to achieving the UNAIDS’ 90-90-90 goals by 2020. We investigated the prevalent HIV-1 genotypes, drug resistance-associated mutations and assessed some predictors of the occurrence of these mutations.MethodsThis was a hospital-based cross-sectional study conducted between October 2010 and June 2012. Participants were consecutively enrolled from selected HIV treatment centers of the Southwest and Northwest regions of Cameroon. Viral load was determined with the automated Abbott Real-time HIV-1 m2000rt System. HIV genotyping and antiretroviral resistance mutations analysis were performed using Bayer’s HIV-1 TRUGENE™ Genotyping Kit and OpenGene DNA Sequencing system. The drug resistance mutation was interpreted with the Stanford HIV database. Epidemiological data were obtained using pre-tested semi-structured questionnaires.ResultsOf the 387 participants, 239 were successfully genotyped. The median age of these participants was 33 years (interquartile range, IQR: 28–40 years), and a majority (65.7%) were female. A total of 29.3% of the participants were receiving ART. The median duration of ART was 10.5 months (IQR: 4–17.25 months). The median CD4 count and log10 viral load of study participants were 353.5 cells/ml (IQR:145–471) and 4.89 copies/ml (IQR: 3.91–5.55) respectively. CRF02 (A/G) (69%) was the most prevalent subtype followed by G (8.2%) and F (6.7%). Overall, resistance mutations were present in 37.1% of ART-experienced and 10.7% of ART-naive patients. Nucleoside reverse transcriptase inhibitors (NRTI) mutations occurred in 30% of ART-experienced and 2.4% of ART-naïve patients, while non-nucleoside reverse transcriptase inhibitors (NNRTI) mutations occurred in 34.2% of ART-experienced and 10.1% of -naïve patients. M184V (8.4%, 20/239) and K103N (5.4%, 13/239) were the most prevalent mutations. Major protease inhibitor mutations occurred in 3 (1.3%) out of the 239 sequences. The duration of ART independently predicted the occurrence of resistance mutation among ART-experienced patients.ConclusionThe high resistance to NNRTIs, which are the main support to the backbone (NRTIs) first-line antiretroviral regimen in Cameroon, has prompted the need to rollout an integrase strand transfer inhibitor regimen (containing Dolutegravir) with a higher genetic barrier to resistance as the preferred first line regimen.

show abstract

“…For NRTIs, 0.6% of patients were predicted to be resistant to Lamivudine and Emtricitabine, which is mostly attributable to the presence of M184V. Lamivudine, Efavirenz and Nevirapine have been prescribed in the first-line regiment of ART in China [ 10 , 35 ]. We therefore considered that the emergence of these mutations may relate to the usage of first-line regimen.…”

Section: Discussionmentioning

confidence: 99%

Epidemiological surveillance of HIV-1 transmitted drug resistance among newly diagnosed individuals in Shijiazhuang, northern China, 2014–2015

et al. 2018

View full text Add to dashboard Cite

BackgroundThe widespread use of antiretroviral therapy (ART) has led to considerable concerns about the prevalence of transmitted drug resistance (TDR). Sexual contact, particularly men who have sex with men (MSM) was the most prevalent form of HIV transmission in Shijiazhuang. Hence, we conducted an epidemiological surveillance study on TDR among newly diagnosed individuals who infected-HIV through sexual contact in from 2014–2015.MethodsGenotypic resistance mutations were defined using the WHO-2009 surveillance list. Potential impact on antiretroviral drug was predicted according to the Stanford HIV db program version 7.0. The role of transmission clusters in drug resistant strains was evaluated by phylogenetic and network analyses.ResultsIn this study, 589 individuals were recruited and 542 samples were amplified and sequenced successfully. The over prevalence of TDR was 6.1%: 1.8% to nucleoside reverse transcriptase inhibitors (NRTIs), 2.0% to non- NRTIs (NNRTIs) and 2.4% to protease inhibitors (PIs), respectively. We did not find significant differences in the TDR prevalence by demographic and clinical characteristics (p > 0.05). Using network and phylogenetic analysis, almost 60.0% sequences were clustered together. Of these clusters, 2 included at least two individuals carrying the same resistance mutation, accounting for 21.2% (7/33) individuals with TDR. No significant difference was observed in the clustering rate between the individuals with and without TDR.ConclusionsWe obtained a moderate level TDR rate in studied region. These findings enhance our understanding of HIV-1 drug resistance prevalence in Shijiazhuang, and may be helpful for the comprehensive prevention and control of HIV-1.

show abstract

HIV drug resistance in HIV positive individuals under antiretroviral treatment in Shandong Province, China

Cited by 14 publications

References 33 publications

Virological failure and HIV drug resistance among adults living with HIV on second‐line antiretroviral therapy in the Asia‐Pacific

Virological failure and HIV drug resistance among adults living with HIV on second‐line antiretroviral therapy in the Asia‐Pacific

Genetic diversity and antiretroviral resistance-associated mutation profile of treated and naive HIV-1 infected patients from the Northwest and Southwest regions of Cameroon

Epidemiological surveillance of HIV-1 transmitted drug resistance among newly diagnosed individuals in Shijiazhuang, northern China, 2014–2015

Contact Info

Product

Resources

About