The Prevalence of Transmitted Antiretroviral Drug Resistance in Treatment-Naive HIV-Infected Individuals in China

Abstract

Background Transmission of HIV drug resistance (TDR) gives rise to reduced efficacy of initial antiretroviral treatment, and has become a public health concern. Methods A nationwide survey on TDR was conducted in antiretroviral therapy naïve HIV-1 infected individuals from September 2004 to October 2005 in China. Drug resistance genotyping was performed on subjects’ plasma samples. Drug resistance mutations were determined and scored by Stanford HIV Drug Resistance algorithm. Results Sequences were obtained from 676 individuals, of which 61.2% were former plasma and blood donors, 17.3% were infected sexually, and 17.2% were intravenous drug users. Subtype B’ HIV-1 strains were found in 73.5%, CRF01_AE in 13.9%, CRF07_BC in 6.2%, CRF08_BC in 2.7%, subtype C in 1.04%, subtype B in 0.9%, CRF02_AG in 0.4% and B’/C intersubtype recombinant strains in 1.3% of the subjects. Twenty-six (3.8%) were found to harbor drug resistance strains. The rates of resistance to PIs, NRTIs and NNRTIs were 0.4%, 1.6% and 2.1%, respectively. Though there was no significant difference in TDR rates between 2004 and 2005 (2.9% vs. 4.4%), an increased trend was observed in the rate of high-level drug resistance (0.8% in 2004 vs. 3.0% in 2005, P = 0.0634). Conclusions The rate of TDR was relatively low in China, as compared with those in developed countries. Surveys among recently HIV-infected subjects should be preformed continually to ensure the success of the scale-up antiretroviral treatment.

Broad Antiviral Activity and Crystal Structure of HIV-1 Fusion Inhibitor Sifuvirtide

“…Recently, the genetic diversity of HIV-1 subtypes has been found in China. According to the epidemiological data, the recombinant forms CRF07_BC and CRF01_AE, and subtype BЈ (Tai B) viruses are responsible for nationwide HIV-1 infections at 50.2, 15.54, and 29.11%, respectively (with a total of ϳ95%) (35,36). It is know that the Env genes of CRF01_BC originate from the subtype C viruses, but some studies indicate that this recombinant form of virus has unique biological characteristics (44 -46).…”

“…Therefore, we constructed a panel of 27 HIV-1 pseudoviruses with their Envs derived from two recombinant forms, CRF01_BC and CRF01_AE, and subtype BЈ viruses that are dominating the AIDS epidemic in China (35,36). The results from the single cycle infection assays are presented in Table 2.…”

Issues in resistance, adherence, and comparative efficacy of the single-tablet regimen combination of tenofovir, emtricitabine, and efavirenz in the management of HIV-1 infection

“…Recent large populationbased studies in the United States, Africa, and Europe have found TDR rates in the range of 6%-16%, with higher levels of resistance in certain urban populations, particularly those who engage in high-risk sex and intravenous drug users (Table 2). [101][102][103][104][105][106][107][108][109][110] In a study of 1277 newly infected patients with HIV-1 in South Carolina, 184 (14%) had TDR. 54 (4%) had an NRTI mutation, 37 (3%) had a PI mutation, and 126 (10%) had an NNRTI mutation.…”

Effect of Viral Load and Drug Resistance on Mortality among Chinese HIV-Infected Patients Receiving Antiretroviral Treatment

“…In samples with viral load ≥1,000 copies/ml, HIV drug resistance genotyping was carried out by an in-house polymerase chain reaction (PCR) procedure as previously described. [9,16] The HIV-1 pol gene (protease, amino acids 1-99; and part of reverse transcriptase, amino acids 1-252) was amplified. For analyzing HIV-1 drug resistance mutations, each sequence was compared with the subtype B consensus sequence in the Stanford HIV Drug Resistance Database (http://hivdb.…”

“…Overall mortality decreased from 39.3 per 100 person-years in 2002 to 14.2 per 100 person-years in 2009, with treatment coverage concomitantly increasing from almost zero to 63.4% [4]. However, like other developing countries using firstline generic antiretroviral regimens, [5][6][7] China is facing an emerging problem of drug resistance [8][9][10] and challenged by high AIDS-related deaths in spite of the expansion of treatment coverage [11]. HIV drug resistance is associated with faster clinical progression and elevated mortality [13][14][15], yet there is currently no evaluation of the effect of virologic failure and drug resistance on mortality among Chinese patients.…”