Drug resistance mutation profiles of the drug-naïve and first-line regimen-treated HIV-1-infected population of Suzhou, China

Abstract

Little is known about the prevalence of drug-resistant mutations in HIV-1-positive individuals in Suzhou, China. To elucidate the transmitted drug resistance (TDR) and acquired drug resistance mutation (ADR) profiles, we collected blood specimens from 127 drug-naïve and 117 first-line drug-treated HIV-1-infected individuals sampled from 2014 to 2016 in Suzhou. We successfully amplified pol fragments from 100 drug-naïve and 20 drug-treated samples. We then determined the drug-resistant mutations to protease (PR) and reverse-transcriptase (RT) inhibitors according to the Stanford drug resistance database. Overall, 11 and 13 individuals had transmitted (drug-naïve group) and acquired (treated group) resistance mutations, respectively. Six transmitted drug-resistant mutations were found, including two mutations (L33F and L76V) in the protease region and four (K70N/E and V179D/E) in the RT region. Only L76V was a major mutation, and K70N/E and V179D/E are known to cause low-level resistance to RT inhibitors. All 13 treated participants who had major drug resistance mutations demonstrated intermediate to high resistance to efavirenz and nevirapine, and six had a treatment duration of less than three months. No major mutations to RT inhibitors were found, implying that the epidemic of transmitted resistance mutations was not significant in this area. Our results suggest that more frequent virus load and drug resistance mutation tests should be conducted for individuals receiving antiretroviral treatment, especially for newly treated patients. Our research provides insights into the occurrence of HIV-1 drug resistance in Suzhou and will help to optimize the treatment strategy for this population.

HIV-1 Drug Resistance and Genetic Transmission Networks Among MSM Failing Antiretroviral Therapy in South China 2014–2019

“…In our study, V179E/D was the most common NNRTI-associated mutation, accounting for 37.9%. 23,[28][29][30][31] and showed broad-spectrum resistance possibly caused by the wide use of NNRTIs.…”

Drug Resistance Mutation L76V Alters Nonpolar Interactions at the Flap–Core Interface of HIV-1 Protease

“… 19 , 20 This mutation occurs with a frequency of around 3% in PI-experienced patients 20 , 21 and can be transmitted to treatment-naive patients. 22 , 23 Inclusion of L76V in mutants bearing three other resistance mutations is associated with two- and eightfold increase in resistance to 1 and 2 , respectively, and an eightfold increase in susceptibility to 6 . 20 …”

Survey of pretreatment HIV drug resistance and the genetic transmission networks among HIV-positive individuals in southwestern China, 2014–2020

“…Since the establishment of China’s national free HIV antiviral therapy in 2003, the case fatality rate of HIV infection has been effectively reduced and the life span of people living with HIV/AIDS has been prolonged [ 1 , 2 ]. However, with the increasing use of antiretroviral drugs, drug resistance has become an urgent problem.…”