Analysis of genotype resistance mutations sites among 123 antiretroviral-therapy failure in HIV/AIDS patients in Yunnan province, China / 中华检验医学杂志

ABSTRACT

Objective To analyze the prevalence and diversity of genotype resistant mutations in 123 HIV/AIDS patients experiencing failure of high antiretroviral therapy (HAART) in Yunnan province.Methods A cross-sectional survey was conducted among 151 HIV/AIDS patients experiencing failure of antiretroviral therapy form January 2011 to January 2012 in Yunnan province.The HIV-1 pol gene was amplified by reverse transcription-polymerase chain reaction (RT-PCR),the sequences were then submitted to the Stanford University HIV drug resistance database to analyze the prevalence of resistant mutations.The resistant mutations were statistically analyzed by gender,ethnic groups,transmission route and subtype,respectively.The chi-square or fisher's exact test was used for statistical test.Results Of the 151 cases,123 plasma samples were amplified successfully for protease PR (codon 1-99) and reverse transcriptase RT (codon 1-272) fragments.The most common mutation was M184 (72.4％),followed by the mutation at position K103 (47.2％),T215 (26.0％),D67 (15.4％),G190 (34.1％),Y181 (29.3％),K101 (17.1％).The frequency of mutations at position V75,A62 and M230 was higher in male population than that in female population (x2 =7.001,6.975,5.446,P ＜ 0.05).The frequency of variants at position Tl215,K70 and T69 was higher in the Han population than in the other ethnic population(x2 =5.290,4.060,3.860,P＜ 0.05).It was interesting that the variant M41L was rare in the other ethnic groups.The significant difference existed at various transmission routes.Frequencies of variants at position T215 and T69 were significantly higher among people infected HIV-I through sexual contact than the intravenous drug users (x2 =10.431,7.952,P ＜ 0.05).Frequencies of variants at position G190 were significantly higher among the intravenous drug users than the population infected HIV-1 through sexual contact(x2 =6.669,P ＜ 0.05),but the variant M230L never occurred in intravenous drug users.The RT mutations V75,T69,M230 were more frequently occurred in patients infected with CRF01_AE than in patients with subtype B (P＜ 0.05).The mutation L74 was never seen in patients infected with CRFOI_AE (P ＜ 0.05).Conclusions The HIV/AIDS patients with failure of high antiretroviral therapy (HAART) were attributed to HIV-1 genotype resistance mutations.The mutation sites among the HAART failure patients from the regions of Dehong,Gejiu,Wenshan and Yuxi were significant difference accordance among the gender,ethnicith,transmission route and subtype,respectively.