Drug resistance mutations and their influencing factors in the patients infected with HIV-1 through different routes after antiretroviral therapy / 解放军医学杂志

ABSTRACT

Objective To analyze HIV-1 drug resistance mutations and relative factors in the patients infected with HIV-1 through different routes after having received highly active anti-retroviral therapy (HAART) in Hebei province. Methods Plasma samples were collected from patients who were infected with HIV through different routes. Detection of HIV-1 RNA pol region was carried out by detection of genotype, and HIV drug resistance mutations were analyzed. Results Among 266 patients, 157 developed mutation. The rate of the drug-resistance was 59.0%. Among 266 patients, drug-resistance rates were ranked from high to low as follows NVP 65.8% (175/266), 3TC 41.7% (111/266), FTC 41.7% (111/266), EFV 30.1% (80/266), DDI 5.6% (15/266), D4T 4.1% (11/266), AZT 3.0% (8/266) and ABC 3.0% (8/266). The drug-resistance rate of blood infection patients was much higher than that of sexual and mother-to-child transmission ones, but χ2-test indicated that the differences in main mutation sites (Y181C, K103N, V108I, K101E in NNRTIS coding region, M184V/I, M41L, T215F, T215Y in NRTIs coding region and A71V/ T, L10I, M46L, Q58E in PIs coding region) were not statistically significant (P>0.05) among the patients infected through three routes. The results of OR value and the 95% confidence interval (CI) indicated that age, infection routes, CD4+ cell count and initial therapeutic plan had a significant relevance to HIV-1 drug resistance mutation (P<0.05). Conclusion Timely monitor of CD4+ cell number, viral load and drug resistance, and evaluation of progression of AIDS, are essential to minimize the influence of related factors on drug resistance, and to renew the therapeutic plan in time during HAART in order to enhance the therapeutic effects.