Tohoku J. Exp. Med., 2019 January, 247(1)

Prevalence of HIV-1 Drug Resistance among Patients with Antiretroviral Therapy Failure in Sichuan, China, 2010-2016

KE DONG,1 LI YE,2 YUN LENG,1 SHU LIANG,2 LIAO FENG,2 HONG YANG,2 LING SU,2 YIPING LI,2 SAIRA BALOCH,1 FANGTING HE,1 DAN YUAN2 and XIAOFANG PEI1

1West China School of Public Health, No.4 West China Teaching Hospital, Sichuan University, Chengdu, Sichuan, China
2Sichuan Provincial Center for Disease Control and Prevention, Center for AIDS/STD Control and Prevention, Chengdu, Sichuan, China

Antiretroviral therapy (ART) has been introduced recently and has significantly impacted morbidity and mortality, but can also engender drug resistance. To identify the prevalence of HIV-1 drug resistance (HIVDR) among patients with antiretroviral therapy failure in Sichuan during the period from 2010 to 2016, we carried out a longitudinal study in Sichuan, a province with the highest HIV/AIDS prevalence in China. The data and blood samples were collected from HIV/AIDS patients who received ART for more than half a year. Overall 5,512 sequences were completed from 7,059 ART-failure patients, and 2,499 individuals were identified as drug resistant. Among those with HIVDR mutations identified, 25.37% were against non-nucleoside reverse transcriptase inhibitors (NNRTIs), and 1.60% was against nucleoside reverse transcriptase inhibitors (NRTIs). NRTI-resistant drugs were mainly lamivudine (3TC) (57.77%) and emtricitabine (FTC), while NNRTI-resistant drugs were mainly nevirapine (NVP) (91.13%) and efavirenz (EFV) (72.81%). The most common recombination subtypes of HIV-1 in sequenced samples were CRF07_BC (circulating recombinant form, CRF) (41.42%), followed by CRF01_AE (40.77%). Moreover, drug resistance rate increased with the prolongation of treatment time (χ2 = 14.758, P < 0.05). The overall prevalence of acquired drug resistance in HIV-1 infected patients in Sichuan was 5.47%, which has remained relatively stable from 2010 to 2016. HIV-1 CRF01_AE and CRF07_BC subtypes were the main epidemic strains, and the possibility of resistance was higher in CRF01_AE subtypes. The current study highlights the importance of acquired drug resistance surveillance over a long period.

keywords —— acquired drug resistance; AIDS; antiretroviral therapy; HIV; Sichuan

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Tohoku J. Exp. Med., 2019, 247, 1-12

Correspondence: Xiaofang Pei, West China School of Public Health, No.4 West China Teaching Hospital, Sichuan University, #16, Section 3, Renmin Nan Lu, Chengdu, Sichuan 610041, China.

e-mail: xxpei@scu.edu.cn

Dan Yuan, Sichuan Provincial Center for Disease Control and Prevention, Center for AIDS/STD Control and Prevention, #6 Zhongxue Road, Wuhou District, Chengdu, Sichuan 610041, China.

e-mail: ydtv1130@163.com