Distribution characteristics of drug resistance mutations of HIV CRF01_AE, CRF07_BC and CRF08_BC from patients under ART in Ganzhou, China

Abstract

Background Drug resistance mutation (DRM)-associated virological failure has become a critical issue for ART and the elimination of HIV. Objectives To investigate the distribution characteristics of DRMs of HIV CRF01_AE, CRF07_BC and CRF08_BC, the predominant subtypes in China. Methods Patients receiving ART up to 31 August 2020 in Ganzhou in China were recruited. Full-length sequences of the HIV pol gene were amplified from patients with virological failure. DRMs and antiretroviral susceptibility were explored using the Stanford University HIV Drug Resistance Database HIVdb Program. Results Overall, 279 of 2204 patients under ART were found to have virological failure. Nine HIV subtypes were identified among 211 sequences that were amplified successfully and CRF08_BC (37.0%), CRF01_AE (26.1%) and CRF07_BC (25.6%) were the most prevalent, with mutation frequencies of 44.9% (35/78), 52.7% (29/55) and 35.2% (19/54), respectively. The most common DRMs of these three subtypes were K103N and M184V, while the mutation frequencies of M41L, D67N, K70R, K101E, V106M, Y181C, K219E, H221Y and N348I were obviously different among subtypes. The resistance levels and frequencies for antiretroviral drugs for these three subtypes were similar and resistances to nevirapine, efavirenz, lamivudine and emtricitabine were the most frequently observed. Compared with CRF01_AE and CRF07_BC, CRF08_BC had higher proportions of DRMs for NRTIs and lower frequencies of resistance to NRTIs and NNRTIs. Conclusions The distribution characteristics of DRMs of HIV CRF01_AE, CRF07_BC and CRF08_BC were inconsistent and should be considered when selecting antiretroviral strategies, developing new drugs and controlling HIV strains containing DRMs.

Establishment and application of a method of tagged-amplicon deep sequencing for low-abundance drug resistance in HIV-1

“…The global HIV-1 drug resistance report released by WHO (2021) pointed out that more and more countries are on the verge of reaching the 10% pre-treatment drug resistance threshold for non-nucleoside reverse transcriptase inhibitors in the WHO releases HIV drug resistance report 2021. As the coverage of antiretroviral drugs expands and patient treatment experience increases, the prevalence of HIV resistance is expected to increase ( Xie et al, 2021 ). The presence of drug-resistant HIV in the viral population, including the minor frequency drug resistance variants ( Palmer et al, 2005 ), is known to compromise virological response to antiretroviral therapy (ART; Soeria-Atmadja et al, 2020 ).…”

Impacts of HIV-1 Subtype Diversity on Long-Term Clinical Outcomes in Antiretroviral Therapy in Guangxi, China

“…[12][13][14] Besides, a recent study revealed that the distributions of drug resistance mutation (DRM) in CRF01_AE, CRF07_BC, and CRF08_BC were inconsistent. 15 Therefore, we hypothesized that long-term clinical outcomes differed between subtypes. Owing to relatively limited clinical data, a previous study in Guangxi between 2014 and 2019 provided insufficient evidence to validate this hypothesis.…”