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

Abstract

BackgroundAssessing the prevalence of HIV-1 drug-resistance and the mutation patterns associated with resistance in the geographical regions implementing free antiretroviral therapy (ART) in China is necessary for preventing the spread of resistant strains and designing the regimens for the subsequent therapies with limited resources.MethodsPlasma samples in different cities/prefectures were collected at Yunnan Provincial Hospital of Infectious Disease from January 2010 to December 2011. Genotyping of drug-resistant individuals was conducted using an in-house assay on plasma samples. Viral load, CD4 T cell counts and demographic data were obtained from medical records and an administered questionnaire.ResultsA total of 609 pol sequences (515 ART-failure and 94 therapy-naïve individuals) derived from 664 samples were obtained. The prevalence of drug-resistance was 45.1% in the ART-failure individuals. Of these, 26.8% harbored HIV strains dually resistant to nucleoside reverse transcriptase inhibitors and non-nucleoside reverse transcriptase inhibitors, and 14.8% harbored HIV strains resistant to only one drug category. Mutations such as M184V/I, K103N, V106A, Y181C and G190A were common among the ART-failure individuals, and the frequencies of M184V/I, K103N and V106A were 28.2%, 19.2%, and 22.1%, respectively. The percentages of individuals exhibiting intermediate or high-level resistance to 3TC, FTC, EFV and NVP drugs were 28.4%, 28.2%, 37.3%, and 37.5%, respectively. Factors such as ethnicity, transmission route, CD4 counts, viral load and the duration of ART were significantly correlated with development of drug resistance in the ART-failure individuals.ConclusionsThe high prevalence of HIV drug-resistance observed among the ART-failure individuals from 2010 to 2011 in Yunnan province should be of increasing concern in regions where the implementation of ART is widespread. Education about the risk factors associated with HIV drug resistance is important for preventing and controlling the spread of HIV drug-resistant strains.

HIV-1 drug-resistant mutations and related risk factors among HIV-1-positive individuals experiencing treatment failure in Hebei Province, China

“…The prevalence of single, dual, and multiple mutations in participants experiencing treatment failure was significantly higher than in ART-naïve participants, which is consistent with previous findings in Yunnan [25]. The dual NRTI and NNRTI DR prevalence (29.4%) was highest, followed by that of NNRTIs (10.7%), NRTIs (4.2%), and PIs (2.8%) in participants experiencing treatment failure.…”

In VitroSelection of HIV-1 CRF08_BC Variants Resistant to Reverse Transcriptase Inhibitors

“…11,12 Studies of HIV-1 RT genotype and phenotype patterns in ARV-naive and treatment failure patients in China are increasing but are still limited. 13,14 Although limited information on drug resistance in the newly emerged CRF08_BC has been obtained from treatment-naive patients, 15 there is still no published information on drug resistance mutation patterns after ARV exposure. In this study, we selected drugresistant variants of CRF08_BC by in vitro passage in peripheral blood mononuclear cells (PBMCs) with escalating concentrations of NVP, EFV, and 3TC, respectively.…”

Different Effects of Nonnucleoside Reverse Transcriptase Inhibitor Resistance Mutations on Cytotoxic T Lymphocyte Recognition between HIV-1 Subtype B and Subtype A/E Infections

“…In Kenya, 15% (8/55) of subtype A-infected patients who had undergone virologic failure had the Y181C, Y181V, or Y181I mutation (34). In China, 11.8% of 515 CRF08_BC, CRF07_BC, and CRF01_AE patients with virologic failure had the Y181C mutation, and 0.6% of them had the Y181V mutation (35). Moreover, 32% of 48 Senegalese children with virologic failure had the Y181C mutation (36).…”