Infection and Drug Resistance (Jul 2023)

Drug Resistance Profile Among HIV-1 Infections Experiencing ART with Low-Level Viral Load in Guangdong China During 2011–2022: A Retrospective Study

  • Lan Y,
  • Ling X,
  • Deng X,
  • Lin Y,
  • Li J,
  • Li L,
  • He R,
  • Cai W,
  • Li F,
  • Li L,
  • Hu F

Journal volume & issue
Vol. Volume 16
pp. 4953 – 4964

Abstract

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Yun Lan,1,* Xuemei Ling,1,2,* Xizi Deng,1,* Yaqing Lin,1 Junbin Li,1,2 Liya Li,1 Ruiying He,1 Weiping Cai,1 Feng Li,1,* Linghua Li,1 Fengyu Hu1 1Guangzhou Eighth People’s Hospital, Guangzhou Medical University, Guangzhou, 510440, People’s Republic of China; 2Guangdong Center for Diagnosis and Treatment of AIDS, Guangzhou, 510060, People’s Republic of China*These authors contributed equally to this workCorrespondence: Fengyu Hu; Linghua Li, Guangzhou Eighth People’s Hospital, Guangzhou Medical University, No. 8 Huaying Road, Baiyun District, Guangzhou, 510440, People’s Republic of China, Email [email protected]; [email protected]: Antiretroviral therapy (ART) efficiently reduces the morbidities and mortalities caused by HIV-1 infection and prevents the HIV epidemic. However, virologic failure (VF) occurs in some patients receiving ART experience, especially increases in those patients with intermittent or persistent low-level viremia (LLV). The presence of drug resistance mutations (DRMs) in LLV was a strong predictor of subsequent VF. The data on drug resistance (DR) or DRMs for HIV-1 infections at low-level viral load (LLVL) are limited in China.Objective: To monitor the prevalence of HIV-1 drug resistance and to evaluate the risk factors associated with drug resistance in LLVL HIV-1 infections during ART in Guangdong, China.Methods: Plasma samples with LLVL during ART in Guangdong Province between Jan 2011 and Dec 2022 were subjected to a modified reverse-transcription PCR with a pre-step of virus concentration by ultracentrifugation before extraction and the Sanger sequencing. Then, the genotypic resistance test was performed and DR was analyzed by the Stanford HIVDB program. Finally, DR-associated factors were identified by logistic regression analysis.Results: We found that CRF01_AE (53.57%) and CRF07_BC (25.07%) were the dominant HIV-1 genotypes in LLVL in Guangdong between 2011 and 2022 but that the percentage of CRF01_AE showed a trend of decrease over time. M46 (1.49%), M184 (30.91%), and K103 (21.46%) were the dominant PI-, NRTI-, and NNRTI-associated mutations, respectively. The total DR rate was 47.06%. Specifically, PI (3.71%) showed a significantly lower DR rate than NNRTI (40.74%) and NRTI (34.14%). Duration of ART, initial ART regimen, ethnicity, and WHO clinical stages were associated with DR.Conclusion: The drug resistance rate among the LLVL during ART in Guangdong, China is high. The risk factors associated with HIV drug resistance should be seriously considered for better control.Keywords: HIV, low-level viral load, drug resistance mutation, drug resistance

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