Study on HIV-1 drug resistance profile of 257 AIDS patients with failure on the first-line antiretroviral treatment in Henan

Abstract

To understand the current situation related to genotypic resistance in patients receiving the first-line antiretroviral treatment, but with with virologic failure, in Henan province and to compare the patterns of drug resistance in patients from different areas. 276 patients with virologic failure on first-line antiretroviral treatment were selected in three different areas of Henan, in 2010. CD4(+)T cells, virus load and genotypic resistance were measured and tested. Prevalence and mutations related to drug-resistant were analyzed. The overall prevalence of drug-resistance was 68.48% in 257 patients, with non-nucleoside reverse transcriptase inhibitor (NNRTIs) as 67.70%. Rate of nucleoside reverse transcriptase inhibitor (NRTIs) was 54.09%, and protease inhibitors (PIs) was 1.18%. The prevalence rates of drug-resistance in A, B and C groups were 82.35%, 97.47% and 52.80%, respectively, and withs significant differences (χ2=50.624, P=0.000). The Prevalence rates related to resistance of NNRTIs and NRTIs were also significantly different (χ2=48.771, P=0.000 and χ2=33.912, P=0.000). 26.46% of the samples had M184V/I mutation which was the highest NRTIs mutation among the 257 patients. The prevalence rates on resistance of A and B were 47.06% and 49.37%, higher than that of C (13.04%, χ2=39.905, P=0.000) followed by TAMs, TAMs-1 and TAMs-2 which were 8.56% and 4.28%. C had the lower prevalence of TAMs-1 than A and B (χ2=13.499, P=0.001). 40.47% of the samples harbored≥1 TAM, with T215Y/F having the most, as 33.85%. 31.13% of 257 patients appeared most NNRTIs mutation K103N in this study, with the prevalence rates also significant different (χ2=14.213, P=0.001) in the three areas. Two PIs mutations were detected in 257 patients: M46I/L, (1.17%) and V82F (0.39%). However, none was detected in area A. Different patterns of drug resistance were found in different areas of Henan province and should be treated differently. The work related to AIDS second-line antiretroviral therapy in Henan should be more opportune, rigorous and standardized.