Drug resistance in HIV-1-infected patients after failed antiretroviral therapy in Suqian, Jiangsu Province / 中华微生物学和免疫学杂志

ABSTRACT

Objective:To evaluate the emergence and prevalence of drug-resistant strains among HIV-1-infected individuals who had failed antiretroviral therapy (ART) in Suqian.Methods:A total of 561 HIV-1-infected patients who had received ART for six months and above in Suqian in 2019 were recruited. Whole blood samples were collected from them with EDTA anticoagulation tubes. Viral loads (VLs) were tested for evaluating the outcomes of ART. HIV-1 subtypes and drug-resistant genotypes were detected if VL in blood samples was ≥1 000 IU/ml for further analyzing the emergence and prevalence of resistant strains.Results:ART successfully suppressed the replication of HIV-1 in 91.1% of the 561 patients (VLs≤1 000 IU/ml). Forty-six HIV-1 pol gene sequences were obtained through RT-PCR from 50 patients experiencing failed ART. Phylogenetic analysis showed that the predominant subtype was CRF07_BC (32.6%), and some new recombinant subtypes (CRF67_01B, CRF79_0107 and CRF87_cpx) were also detected. Drug-resistant strains mainly caused by K65R (30.8%), M184V/I (30.8%), K103N (19.2%), Y181C (23.1%) and G190A/S (23.1%) mutations were isolated form 56.5% of the patients failed to respond to ART. ART failure in the cases (43.5%) negative for drug-resistant strains might result from non-adherence. Conclusions:CRF07_BC was the predominant subtype of HIV-1 circulating in Suqian and various new recombinant subtypes were emerged. Drug resistance might be the main cause of ART failure. It was very necessary to enhance the adherence education during the course of ART for suppressing the replication of HIV-1 and preventing from the emergence of drug-resistant strains.