Emerging trends of drug-resistant HIV-1 among drug-treated patients in former blood donors in Hubei, China: a three-year surveillance from 2004 to 2006

Abstract

This study aimed to evaluate emerging trends of drug resistance to nucleoside reverse transcriptase inhibitors (NRTIs) and nonnucleoside reverse transcriptase inhibitors (NNRTIs) among 290 former blood donor HIV-1 infected patients in Hubei, China, from 2004 to 2006, all of whom had received anti-HIV-1 therapy. The presence of NRTI- and NNRTI-associated mutations were established by sequencing; genotypic and predicted phenotypic drug resistance were evaluated using HIVdb Program version 5.0.1 (http://hivdb.stanford.edu/pages/algs/HIVdb.html ). Genotypic drug resistance analysis showed significant increases in percentages of patients carrying HIV-1 strains with M41L, T215Y/F, D67N, K103N, G190A/S, Y181C/F or L210W mutations. Of the variants' predicted phenotypic drug resistance, highly significant increases were detected in percentages of patients carrying HIV-1 with high resistance to zidovudine (AZT) or stavudine (D4T) in NRTIs, and to delavirdine (DLV), efavirenz (EFV) or nevirapine (NVP) in NNRTIs; intermediate resistance to abacavir (ABC), AZT, D4T, didanosine (DDI) or tenofovir disoproxil fumarate (TDF) in NRTIs, and to etravirine (ETR) in NNRTIs; and low and potential low resistance to lamivudine (3TC), ABC, emtricitabine (FTC) or TDF in NRTIs, and to ETR in NNRTIs.

Incidence and Associated Factors of HIV Drug Resistance in Chinese HIV-Infected Patients Receiving Antiretroviral Treatment

“…Previous studies have reported that DDI-based regimens are associated with higher rates of emergence of liver disease, [13] virologic failure, [14] prevalence of HIVDR [15]–[17] and mortality. [18] It is possible that because DDI is associated with more side effects compared with 3TC-based regimens, patients are less likely to stay adherent to drug intake and clinical visits.…”

Prevalence and Mutation Patterns of HIV Drug Resistance from 2010 to 2011 among ART-Failure Individuals in the Yunnan Province, China

“…The reports showed that 34.2% of former paid blood donor individuals in the Henan province [17] had at least one drug-resistance mutation to one antiviral drug, 23.7% were cross-resistant to NRTIs and NNRTIs after a 12-month duration and the prevalence of drug resistance in the ART individuals in a cross-section survey from 2004 to 2006 in the Hubei province [18]. In the present study, the prevalence of drug resistance was lower (2.1%) in the therapy-naïve than the ART-failure individuals, which was consistent with the results reported in the domestic study [19]–[20].…”

Structure of a Dihydroxycoumarin Active-Site Inhibitor in Complex with the RNase H Domain of HIV-1 Reverse Transcriptase and Structure–Activity Analysis of Inhibitor Analogs

“…Both activities are essential for HIV replication 3; 4 ; yet, all current RT-directed therapeutics target only RT DNA polymerase activity. The continued emergence of HIV variants resistant to these and all other clinically used drugs 5; 6; 7; 8; 9 underscores the need to develop drugs against new targets such as RNase H that may be effective against resistant viruses. Despite considerable effort, no clinically useful drugs targeting RT RNase H have been developed.…”