A survey of the distribution of HIV subtypes and drug resistance in HIV-infected patients receiving antiretroviral treatment in Yili prefecture of Xinjiang, China

Abstract

Objective To investigate the distribution of HIV-1 subtypes and the prevalence of drug resistance in AIDS patients receiving antiretroviral treatment in Xinjiang, China. Methods Six hundred patients who were aged ≥18 years and received antiretroviral treatment were recruited in this study in 2013 by using cluster sampling. Blood samples were collected from the patients. The numbers of CD4+ T lymphocytes in peripheral blood samples were measured by using fluorescence activated cell sorting. HIV-1 RNA 3.0 assay was used to detect the viral loads. Nested RT-PCR was performed to amplify the fragments of HIV-1 pol gene extracted from patients whose viral loads ≥1000 copies/ml. The resistant mutations were determined by comparing the sequences with those recorded in Stanford HIV Drug Resistance Database. The factors associated with HIV drug resistance (HIVDR) were identified by using logistic regression analysis. Results Among the 600 patients, 149 patients were screened out with a viral load ≥ 1000 copies/ml. One hundred and forty-six sequences of pol gene were successfully amplified. Drug resistance was detected in 57 patients out of the 600 HIV-infected patients receiving antiretroviral treatment with an overall drug resistance rate of 9.50%. The predominant subtype of HIV-1 in Yili prefecture was CRF07_BC subtype (99.5%, 189/190). Only one B subtype strain of HIV-1 was detected. The factors associated with HIVDR included missed doses in the last month and switching to second-line regiments. Conclusion The incidence of HIVDR among HIV-infected patients receiving antiretroviral treatment was relatively high. It is necessary to improve the therapeutic effects of antiretroviral treatment by enhancing the education on medication compliance for patients and strengthening the surveillance of drug resistance. Key words: HIV; Highly active antiretroviral therapy; Drug resistance