Abstract

BackgroundThe overall success of Human immunodeficiency virus type 1 (HIV-1) antiretroviral therapy (ART) was heavily challenged upon the occurrence of drug resistance. Dehong Prefecture witnessed not only the first report of HIV-1 infection but also the experimental adoption of antiviral treatment in China. The transmission and epidemic of HIV-1 in Dehong is impacted by cross-border activities. The characteristics of HIV-1 drug resistance among therapy-naïve Burmese entering travelers in Yunnan and their speculated origin are still not clarified.MethodsTwo hundred ninety-eight HIV-1 infected Burmese entering travelers at Dehong ports were recruited between 2003 and 2012. The partial HIV-1 pol gene fragments were amplified and sequenced for the analysis of drug-resistance mutations (DRMs). Phylogenetic analysis on gag-pol gene was conducted to elucidate phylogenetic and evolutionary characteristics of these drug resistant strains.ResultsIt was figured out that the occurrence ratio of HIV-1 drug resistance among HIV-1 infected entering travelers from Myanmar was up to 12.8%. The resistant mutations covered several types, including one type of PI mutations (L33F), six types of NRTI mutations and seven types of NNRTI. Close genetic relationship was observed in the phylogenetic analysis on gag-pol gene among the drug resistant strains respectively from Dehong, other Yunnan areas, neighboring provinces (Guangxi) and neighboring countries (Thailand and Myanmar).ConclusionsThe findings in this study revealed that HIV drug resistant locus is spreading from the population who is receiving drug-resistance treatment to the new infectors, which indicates the urgency of surveillance work on drug resistance among the migrant population with high risks of HIV infection.

Highlights

  • The overall success of Human immunodeficiency virus type 1 (HIV-1) antiretroviral therapy (ART) was heavily challenged upon the occurrence of drug resistance

  • HIV-1 drug resistance occured in a substantial proportion of treated patients and accumulated over time with the long-term use of ART [4]

  • We have confirmed that HIV infection ratio (5.12%) of entering travelers at Dehong port is higher than any other ports in Yunnan [8]

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Summary

Introduction

The overall success of Human immunodeficiency virus type 1 (HIV-1) antiretroviral therapy (ART) was heavily challenged upon the occurrence of drug resistance. Dehong Prefecture witnessed the first report of HIV-1 infection and the experimental adoption of antiviral treatment in China. HIV-1 drug resistance occured in a substantial proportion of treated patients and accumulated over time with the long-term use of ART [4]. Drug resistance has become the magnificent challenge for current antiretroviral therapy, especially in developing countries. In the wake of implementation of ART, resistant strains carrying drug-resistant mutations have been increasingly prevalent [5]. TDR has been a major difficulty and an intensive focus in AIDS treatment and HIV surveillance

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