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#35972723   2022/08/16 To Up

Prevalence of drug resistance and genetic transmission networks among HIV/AIDS patients with antiretroviral therapy failure in Guangxi, China.

Prevalence of drug resistance (DR) challenges the epidemic control of HIV-1. However, little is known about DR among patients with antiretroviral therapy (ART) failure in Guangxi province, China. This cross-sectional study was aimed to investigate the prevalence of DR and the characteristics of DR sequences in the genetic transmission network among HIV-1 patients with ART failure in Guangxi. We enrolled 358 eligible patients between 2012 and 2018. Blood samples were subjected to RT-PCR, followed by sequencing of the HIV-1 polymerase (pol) gene. An online subtyping tool and Neighbor-joining (NJ) phylogenetic tree were used to determine the genotype. HIV-TRACE tool was used to constructed transmission network with a pairwise genetic distance of 0.013. DR was analyzed using the Stanford University HIV Drug Resistance Database. We obtained 293 pol-sequences from participants, CRF01_AE (75.4%), CRF 08_BC (15.7%) and CRF07_BC (8.5%) were the main subtypes, and an A1 subtype was detected in Guangxi for the first time. The overall prevalence of DR was 32.4% (95/293). Among those with identified DR, 25.6% were against non-nucleoside analogue reverse-transcriptase inhibitors (NNRTIs), 17.7% were against nucleoside analogue reverse-transcriptase inhibitors (NRTIs), and 14.3% were against both NRTIs and NNRTIs. The common drug resistant mutations (DRMs) were M184V (10.2%), K103N (10.6%) and V179D (6.1%). The patients located in the southern Guangxi (AOR=10.87), or whose blood plasma were taken in 2017-2018 (AOR=3.98) had an increased risk of DR. Of the CRF01_AE, CRF07_BC, and CRF08_BC sequences, 18.6%, 8.0%, and 13.0% fell into clusters, respectively. Nine (9.7%) sequences from patients with DR fell into three clusters. The largest cluster containing 11 individuals was the CRF01_AE subtype, 27.3% of whom were DR patients. Although the prevalence of DR among ART failure patients in Guangxi was at a low level, the continuous surveillance of DR in ART-patients is necessary.
Dee Yu, Bingyu Liang, Yuan Yang, Jie Liu, Huayue Liang, Fei Zhang, Jiaxiao Jiang, Jiegang Huang, Shanmei Zhong, Cai Qin, Junjun Jiang, Hao Liang, Li Ye

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