HIV-1 Drug Resistance Profiles of Low-Level Viremia Patients and Factors Associated With the Treatment Effect of ART-Treated Patients: A Cross-Sectional Study in Jiangsu, China

Yuan, Defu; Zhou, Ying; Shi, Lingen; Liu, Yangyang; Lu, Jing; Chen, Jianshuang; Fu, Gengfeng; Wang, Bei

doi:10.3389/fpubh.2022.944990

Cited by 5 publications

(5 citation statements)

References 52 publications

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“…[38][39][40] Here we found that the overall DR rate in LLVL in Guangdong was 47.06%, especially in NRTI and NNRTI with lower resistance barriers such as FTC/3TC/ABC or EFV/NVP, which is lower than our previous results in MSM (64.12%, 252/393) 41 or sexual transmission (64.74%, 123/190) 42 with HIV-1 VL>1000 after ART (χ2=38.479 or 21.776, p<0.001). The overall DR rate in LLVL in Guangdong is similar to that in LLV in other provinces of China such as Beijing (36.59%, 15/41, or 38.81%, 26/67) 19,28 and Jiangsu (40.50%, 98/242), 20 but is significantly lower than that in LLV in Rome, Italy (67.96%, 925/1361) 7 (χ 2 =1.771, 1.775, 3.753 or 145.32, p= 0.183, 0.183, 0.053 or <0.001). The difference between ART-experienced patients with VL 200-999 and those with VL >1000 in Guangdong may be due to the ART-experienced patients with lower VL have lower medication compliance, while the difference between ARTexperienced patients with VL 200-1000 in China and other countries may due to the different genotype distribution or treatment regimen, the specific reasons still need to be explored in a future study.…”

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confidence: 54%

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Drug Resistance Profile Among HIV-1 Infections Experiencing ART with Low-Level Viral Load in Guangdong China During 2011–2022: A Retrospective Study

Lan,

Ling,

Deng

et al. 2023

IDR

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Background: Antiretroviral therapy (ART) efficiently reduces the morbidities and mortalities caused by HIV-1 infection and prevents the HIV epidemic. However, virologic failure (VF) occurs in some patients receiving ART experience, especially increases in those patients with intermittent or persistent low-level viremia (LLV). The presence of drug resistance mutations (DRMs) in LLV was a strong predictor of subsequent VF. The data on drug resistance (DR) or DRMs for HIV-1 infections at low-level viral load (LLVL) are limited in China. Objective: To monitor the prevalence of HIV-1 drug resistance and to evaluate the risk factors associated with drug resistance in LLVL HIV-1 infections during ART in Guangdong, China. Methods: Plasma samples with LLVL during ART in Guangdong Province between Jan 2011 and Dec 2022 were subjected to a modified reverse-transcription PCR with a pre-step of virus concentration by ultracentrifugation before extraction and the Sanger sequencing. Then, the genotypic resistance test was performed and DR was analyzed by the Stanford HIVDB program. Finally, DRassociated factors were identified by logistic regression analysis. Results: We found that CRF01_AE (53.57%) and CRF07_BC (25.07%) were the dominant HIV-1 genotypes in LLVL in Guangdong between 2011 and 2022 but that the percentage of CRF01_AE showed a trend of decrease over time. M46 (1.49%), M184 (30.91%), and K103 (21.46%) were the dominant PI-, NRTI-, and NNRTI-associated mutations, respectively. The total DR rate was 47.06%. Specifically, PI (3.71%) showed a significantly lower DR rate than NNRTI (40.74%) and NRTI (34.14%). Duration of ART, initial ART regimen, ethnicity, and WHO clinical stages were associated with DR. Conclusion:The drug resistance rate among the LLVL during ART in Guangdong, China is high. The risk factors associated with HIV drug resistance should be seriously considered for better control.

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confidence: 54%

“…The data on DR or DRM at LLVL are limited in China. 19,20 In this study, we investigated the prevalence of HIV DR among ART-experienced patients with viral loads between 200 and 1000 in Guangdong Province (China), from 2011 to 2022, to provide guidance on the implementation of treatment and medication on LLVL.…”

Section: Introductionmentioning

confidence: 99%

Drug Resistance Profile Among HIV-1 Infections Experiencing ART with Low-Level Viral Load in Guangdong China During 2011–2022: A Retrospective Study

Lan,

Ling,

Deng

et al. 2023

IDR

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“…Although LLV has been associated with sub‐optimal treatment adherence [33], it has also been associated with HIV drug resistance. For instance, a study in China showed that 40.5% of people living with HIV with LLV had HIV drug resistance [50]. A study from Lesotho reported that 84% of people living with HIV with LLV taking a non‐nucleoside reverse transcriptase inhibitor‐based first‐line regimen had HIV drug‐resistance mutations [51].…”

Section: Discussionmentioning

confidence: 99%

Effectiveness of intensive adherence counselling in achieving an undetectable viral load among people on antiretroviral therapy with low‐level viraemia in Uganda

Nanyeenya,

Nakanjako,

Makumbi

et al. 2023

HIV Medicine

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IntroductionUganda was using a threshold of 1000 copies/mL to determine viral non‐suppression for antiretroviral therapy monitoring among people living with HIV, prior to this study. It was not clear whether people living with HIV with low‐level viraemia (LLV, ≥50 to <1000 copies/mL) would benefit from intensive adherence counselling (IAC). The purpose of this study was to determine the effectiveness of IAC among people living with HIV, receiving antiretroviral therapy, and with LLV in Uganda, to guide key policy decisions in HIV care, including the review of the viral load (VL) testing algorithm.MethodsThis cluster‐randomized clinical trial comprised adults from eight HIV clinics who were living with HIV, receiving ART, and had recent VL results indicating LLV (tested from July 2022 to October 2022). Participants in the intervention arm clinics received three once‐monthly sessions of IAC, and those in the comparison non‐intervention arm clinics received the standard of care. At the end of the study, all participants were re‐tested for VL to determine the proportions of those who then had an undetectable VL (<50 copies/mL). We assessed the statistical association between cross‐tabulated variables using Fisher's exact test and then modified Poisson regression.ResultsA total of 136 participants were enrolled into the study at eight HIV clinics. All 68 participants in the intervention arm completed all IAC sessions. Only one participant in the non‐intervention arm was lost to follow‐up. The average follow‐up time was 3.7 months (standard deviation [SD] 0.2) and 3.5 months (SD 0.1) in the intervention and non‐intervention arms, respectively.In total, 59 (43.7%) of 135 people living with HIV achieved an undetectable VL during the study follow‐up period. The effect of IAC on attaining an undetectable VL among people with LLV was nearly twice as high in the intervention arm (57.4%) than in the non‐intervention arm (29.9%): adjusted risk ratio 1.9 (95% confidence interval 1.0–3.5), p = 0.037.ConclusionIAC doubled the likelihood of an undetectable VL among people living with HIV with LLV. Therefore, IAC has been instituted as an intervention to manage people living with HIV with LLV in Uganda, and this should also be adopted in other Sub‐Saharan African countries with similar settings.ClinicalTrials.Gov IdentifierNCT05514418.

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“…Sample collection, experimental manipulation, and sequence processing have been described in a previous study [ 10 ]. According to the Technical Guide for HIV Transmission Networks Monitoring and Intervention (2021 trial version) published by the Chinese Center for Disease Control and Prevention, the phylogenetic tree was first constructed using Fasttree (version: 1.4.3), and the number of clusters and edges under different thresholds was calculated using ClusterPicker (version: 1.2.5) and Hyphy (version: 2.2.4) software, respectively, combining the information from both to select the optimal gene distance threshold ( Supplementary Material Figure S1 ) and complete the visualization of the molecular transmission network using Cytoscape software (version: 3.9.1).…”

Section: Methodsmentioning

confidence: 99%

Prevention and Control Are Not a Regional Matter: A Spatial Correlation and Molecular Linkage Analysis Based on Newly Reported HIV/AIDS Patients in 2021 in Jiangsu, China

Yuan,

Liu,

Ouyang

et al. 2023

Viruses

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HIV-related spatial analysis studies in China are relatively few, and Jiangsu Province has not reported the relevant data in recent years. To describe the spatial distribution and molecular linkage characteristics of HIV-infected patients, this article combined descriptive epidemiology, spatial analysis, and molecular epidemiology methods to analyze patient reporting, patient mobility information, and HIV sequence information simultaneously. The results showed that HIV reporting profiles differed among Jiangsu cities, with the reporting rate in southern Jiangsu being above average. There was a spatial autocorrelation (Global Moran I = 0.5426, p < 0.05), with Chang Zhou showing a High–High aggregation pattern. Chang Zhou and Wu Xi were identified as hotspots for HIV reporting and access to molecular transmission networks. Some infected individuals still showed cross-city or even cross-province mobility after diagnosis, and three were linked with individuals in the destination cities within the largest molecular transmission cluster, involving 196 patients. The cross-city or cross-province mobility of patients may result in a potential HIV transmission risk, suggesting that combining timely social network surveys, building an extensive transmission network across cities and provinces, and taking critical regions and key populations as entry points could contribute to improved prevention and control efficiency and promote achievement of the 95-95-95 target and cascade.

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HIV-1 Drug Resistance Profiles of Low-Level Viremia Patients and Factors Associated With the Treatment Effect of ART-Treated Patients: A Cross-Sectional Study in Jiangsu, China

Cited by 5 publications

References 52 publications

Drug Resistance Profile Among HIV-1 Infections Experiencing ART with Low-Level Viral Load in Guangdong China During 2011–2022: A Retrospective Study

Drug Resistance Profile Among HIV-1 Infections Experiencing ART with Low-Level Viral Load in Guangdong China During 2011–2022: A Retrospective Study

Effectiveness of intensive adherence counselling in achieving an undetectable viral load among people on antiretroviral therapy with low‐level viraemia in Uganda

Prevention and Control Are Not a Regional Matter: A Spatial Correlation and Molecular Linkage Analysis Based on Newly Reported HIV/AIDS Patients in 2021 in Jiangsu, China

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