Infectious Diseases of Poverty (May 2020)

Pretreatment HIV drug resistance in adults initiating antiretroviral therapy in China, 2017

  • Rui-Hua Kang,
  • Shu-Jia Liang,
  • Yan-Ling Ma,
  • Shu Liang,
  • Lin Xiao,
  • Xin-Hui Zhang,
  • Hong-Yan Lu,
  • Xiao-Qin Xu,
  • Shui-Bin Luo,
  • Xiao-Guang Sun,
  • Lin Chen,
  • Jian-Mei He,
  • Guo-Hui Wu,
  • Ling-Jie Liao,
  • Hui Xing,
  • Yi-Ming Shao,
  • Yu-Hua Ruan

DOI
https://doi.org/10.1186/s40249-020-00668-5
Journal volume & issue
Vol. 9, no. 1
pp. 1 – 9

Abstract

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Abstract Background After the scale-up of antiretroviral therapy (ART) for HIV infected people, increasing numbers of patients have pretreatment drug resistance (PDR). In this study, the prevalence of PDR was evaluated in adults initiating antiretroviral therapy in China. Methods Blood samples were obtained from 1943 patients who initiated antiretroviral therapy (ART) in 2017 from 13 provinces or cities in China. Pol sequences were used to analyze drug resistance and construct transmission networks. Logistic regression model was used to estimate the potential factors associated with PDR. Results In total, 1711 eligible patients (76.0% male; 87.8% aged ≥ 25 years) were included, of which 117 (6.8%) had PDR. The highest rates of PDR were 12.2% in Liangshan Prefecture of Sichuan and 9.3 and 8.9% in Dehong and Lincang Prefecture of Yunnan. A multivariate logistic regression analysis revealed that PDR was significantly higher among intravenous drug users (adjusted Odds Ratio (aOR) = 2.64, 95% CI: 1.57–4.44) and individuals from Liangshan, Dehong, and Lincang (aOR = 2.04, 95% CI: 1.26–3.30). In total, 754 sequences were used to generate 164 transmission networks. Five transmission networks had two or three sequences containing the same mutations, two networks contained subjects from Liangshan, and one network contained subjects from Dehong. Conclusions Overall, the PDR prevalence was moderate, with a particularly high prevalence in areas with severe HIV epidemics. These results indicate the importance of continuous PDR monitoring in patients initiating antiretroviral therapy.

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