HIV-1 Subtype Diversity and Factors Affecting Drug Resistance among Patients with Virologic Failure in Antiretroviral Therapy in Hainan Province, China, 2014–2020
De E YU , Yu Jun XU , Mu LI , Yuan YANG , Hua Yue LIANG , Shan Mei ZHONG , Cai QIN , Ya Nan LAN , Da Wei LI , Ji Peng YU , Yuan PANG , Xue Qiu QIN , Hao LIANG , Kao Kao ZHU , Li YE , Bing Yu LIANG
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Abstract
Objective
This study aimed to determine the HIV-1 subtype distribution and HIV drug resistance (HIVDR) in patients with ART failure from 2014 to 2020 in Hainan, China.
Methods
A 7-year cross-sectional study was conducted among HIV/AIDS patients with ART failure in Hainan. We used online subtyping tools and the maximum likelihood phylogenetic tree to confirm the HIV subtypes with pol sequences. Drug resistance mutations (DRMs) were analyzed using the Stanford University HIV Drug Resistance Database.
Results
A total of 307 HIV-infected patients with ART failure were included, and 241 available pol sequences were obtained. Among 241 patients, CRF01_AE accounted for 68.88%, followed by CRF07_BC (17.00%) and eight other subtypes (14.12%). The overall prevalence of HIVDR was 61.41%, and the HIVDR against non-nucleoside reverse transcriptase inhibitors (NNRTIs), nucleotide reverse transcriptase inhibitors (NRTIs), and protease inhibitors (PIs) were 59.75%, 45.64%, and 2.49%, respectively. Unemployed patients, hypoimmunity or opportunistic infections in individuals, and samples from 2017 to 2020 increased the odd ratios of HIVDR. Also, HIVDR was less likely to affect female patients. The common DRMs to NNRTIs were K103N (21.99%) and Y181C (20.33%), and M184V (28.21%) and K65R (19.09%) were the main DRMs against NRTIs.
Conclusion
The present study highlights the HIV-1 subtype diversity in Hainan and the importance of HIVDR surveillance over a long period.
期刊介绍：
Biomedical and Environmental Sciences (BES) is a peer-reviewed journal jointly established by the Chinese Center for Disease Control and Prevention (China CDC) and the Coulston International Corporation (CIC), USA in 1988, and is published monthly by Elsevier. It is indexed by SCI, PubMed, and CA.
Topics covered by BES include infectious disease prevention, chronic and non-communicable disease prevention, disease control based on preventive medicine, and public health theories. It also focuses on the health impacts of environmental factors in people''s daily lives and work, including air quality, occupational hazards, and radiation hazards.
Article types considered for publication include original articles, letters to the editor, reviews, research highlights, and policy forum.
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