Prevalence of acquired drug resistance mutations in antiretroviral- experiencing subjects from 2012 to 2017 in Hunan Province of central South China

Abstract

Background: There are few data on the prevalence of acquired drug resistance mutations (ADRs) in Hunan Province, China, that could affect the effectiveness of antiretroviral therapy (ART). Objectives: The main objectives of this study were to determine the prevalence of acquired drug resistance (ADR) the epidemic characteristics of HIV-1-resistant strains among ART-failed HIV patients in Hunan Province, China. Methods: ART-experienced and virus suppression failure subjects in Hunan between 2012 and 2017 were evaluated by genotyping analysis and mutations were scored using the HIVdb.stanford.edu algorithm to infer drug susceptibility. Results: The prevalence of HIV-1 ADR were 2.76, 2.30, 2.98, 2.62, 2.23and 2.17%, respectively, from 2012 to 2017. Overall 2295 sequences were completed from 2932 ART-failure patients, and 914 of these sequences were found to have drug resistance mutation. The most common subtype was AE (64.14%), followed by BC (17.91%) and B (11.50%). Among those 914 patients with drug resistance mutations,93.11% had NNRTI-associated drug resistance mutations, 74.40% had NRTI drug resistance mutations (DRMs) and 6.89% had PI DRMs. Dual-class mutations were observed in 591 (64.66%) cases, and triple-class mutations were observed in 43 (4.70%) cases. M184V (62.04%), K103N (41.90%) and I54L (3.83%) were the most common observed mutations, respectively, in NRTI-, NNRTI-and PIassociated drug resistance. 93.76% subjects who had DRMs received the ART first-line regimens. CD4 count, symptoms in the past 3 months, and ART adherence were found to be associated with HIV-1 DR. Conclusions: This study showed that although the prevalence of HIV-acquired resistance in Hunan Province is at a low-level, the long-term and continuous surveillance of HIV ADR in antiretroviral drugs (ARVs) patients is necessary.

HIV-1 Drug Resistance and Genetic Transmission Networks Among MSM Failing Antiretroviral Therapy in South China 2014–2019

“… 27 V179E/D does not appear to reduce the virological response to a first-line EFV-containing regimen. 15 V106I/M, K103N/Q, G190A/S, and Y181C were the major NNRTI-associated mutations, similar to those in other cities in China and other countries, 23 , 28–31 and showed broad-spectrum resistance possibly caused by the wide use of NNRTIs.…”

“…The overall prevalence of drug resistance was 66.7% in MSM with ART failure in Guangdong, which was similar to that in Yunnan (66.27% in MSM with ART failure from 2014 to 2019) 21 and relatively higher than those in other areas of China, such as Sichuan (50.7% in MSM with ART failure from 2011 to 2017) 22 and Hunan (41.3% in MSM with ART failure from 2012 to 2017). 23 …”

“…20 The overall prevalence of drug resistance was 66.7% in MSM with ART failure in Guangdong, which was similar to that in Yunnan (66.27% in MSM with ART failure from 2014 to 2019) 21 and relatively higher than those in other areas of China, such as Sichuan (50.7% in MSM with ART failure from 2011 to 2017) 22 and Hunan (41.3% in MSM with ART failure from 2012 to 2017). 23 M184I/V (42.2%) was the most prevalent NRTIassociated mutation, which might be caused by the frequent use of 3TC in ART-experienced patients. 24 This caused high-level resistance to 3TC and Emtricitabine (FTC) and low-level resistance to Abacavir (ABC) and Didanosine (DDI).…”

“…In our study, V179E/D was the most common NNRTI-associated mutation, accounting for 37.9%. 23,[28][29][30][31] and showed broad-spectrum resistance possibly caused by the wide use of NNRTIs.…”

Trends of Transmitted and Acquired Drug Resistance in Europe From 1981 to 2019: A Comparison Between the Populations of Late Presenters and Non-late Presenters

“…The most common DRMs among ART-naïve and ART-experienced patients for nucleoside reverse transcriptase inhibitors (NRTIs) were M41L and M184V, respectively, and K103N for NNRTIs ( Rossetti et al, 2018 ; Zou et al, 2020 ).…”