Prevalence of drug resistance mutations in low-level viremia patients under antiretroviral therapy in Southwestern China: a cross-sectional study.

IF 3.9 2区医学 Q1 INFECTIOUS DISEASES Journal of Antimicrobial Chemotherapy Pub Date : 2025-01-21 DOI:10.1093/jac/dkaf017

Yuanlu Shu, Jiafa Liu, Cuixian Yang, Jianjian Li, Mi Zhang, Yuan Li, Xuemei Deng, Xingqi Dong

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Abstract

Objectives: This study aimed to evaluate the prevalence and characteristics of drug resistance mutations (DRMs) in patients with low-level viremia (LLV) in Southwestern China, as it has become a growing challenge in AIDS clinical practice.

Methods: This cross-sectional study was performed in Yunnan Province, Southwestern China. LLV was defined as 50-999 copies/mL of plasma viral load with antiretroviral therapy (ART) for at least 6 months. HIV-1 DRM detection used validated in-house protocol.

Results: A total of 470 sequences were obtained, and 13 HIV-1 genotypes were identified, among which CRF08_BC (47.5%), CRF07_BC (22.3%) and CRF01_AE (10.0%) subtypes were the most prevalent. The overall prevalence of DRMs was 45.7% (215/470), and the prevalence of DRMs to non-nucleoside reverse transcriptase inhibitors (NNRTIs), nucleoside reverse transcriptase inhibitors (NRTIs) and protease inhibitors (PIs) was 39.4% (185/470), 20.6% (97/470) and 5.3% (25/470), respectively. The most common NNRTI-associated mutations were K103N (16.0%), E138A (6.6%), V179D (6.6%) and P225H (4.9%), and those in NRTIs were M184V (17.0%), D67N (3.4%) and K65R (3.0%). PI-associated mutations were infrequent, occurring in less than 1.8% of cases. The prevalence of NNRTI-associated mutations (K101E and Y188C) was found to be statistically significant among various LLV groups. Additionally, significant variations were observed in the prevalence of NNRTI-associated mutations (V106I, V106M, E138A and P225H), NRTI-associated mutation (K65R) and PI-associated mutations (L33F and Q58E) across different subtypes.

Conclusions: The prevalence of DRMs in ART-experienced patients with LLV was high, and HIV-1 genotypes exhibited diversity in Yunnan Province. These findings indicate that regular DRM monitoring during LLV episodes was essential for effective clinical treatment and management in this region.

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中国西南地区接受抗逆转录病毒治疗的低水平病毒血症患者耐药突变发生率：一项横断面研究

目的：本研究旨在评估中国西南地区低水平病毒血症（LLV）患者的耐药突变（DRMs）的患病率和特征，因为它已成为艾滋病临床实践中越来越大的挑战。方法：本横断面研究在中国西南部云南省进行。LLV被定义为接受抗逆转录病毒治疗（ART）至少6个月的50-999拷贝/mL血浆病毒载量。HIV-1 DRM检测使用经过验证的内部协议。结果：共获得470条序列，共鉴定出13种HIV-1基因型，其中以CRF08_BC（47.5%）、CRF07_BC（22.3%）和CRF01_AE（10.0%）亚型最为常见。DRMs的总患病率为45.7%(215/470)，其中非核苷类逆转录酶抑制剂（NNRTIs）、核苷类逆转录酶抑制剂（NRTIs）和蛋白酶抑制剂（pi）的DRMs患病率分别为39.4%（185/470）、20.6%（97/470）和5.3%（25/470）。最常见的nnrti相关突变为K103N（16.0%）、E138A（6.6%）、V179D（6.6%）和P225H (4.9%)， nrti中最常见的突变为M184V（17.0%）、D67N（3.4%）和K65R（3.0%）。pi相关突变不常见，发生在不到1.8%的病例中。nnrti相关突变（K101E和Y188C）的患病率在不同LLV组中具有统计学意义。此外，不同亚型的nnrti相关突变（V106I、V106M、E138A和P225H）、nnrti相关突变（K65R）和pi相关突变（L33F和Q58E）的患病率也存在显著差异。结论：云南省接受抗逆转录病毒治疗的LLV患者drm患病率较高，且HIV-1基因型具有多样性。这些发现表明，在LLV发作期间定期监测DRM对于该地区有效的临床治疗和管理至关重要。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Antimicrobial Chemotherapy 医学-传染病学

CiteScore

9.20

自引率

5.80%

发文量

423

审稿时长

2-4 weeks

期刊介绍： The Journal publishes articles that further knowledge and advance the science and application of antimicrobial chemotherapy with antibiotics and antifungal, antiviral and antiprotozoal agents. The Journal publishes primarily in human medicine, and articles in veterinary medicine likely to have an impact on global health.