Pretreatment drug resistance in people living with HIV: A large retrospective cohort study in Chongqing, China

• Published in: HIV medicine Vol. 23; no. S1; pp. 95 - 105
• Main Authors: Liu, Min, He, Xiao‐Qing, Deng, Ren‐Ni, Tang, Sheng‐Quan, Harypursat, Vijay, Lu, Yan‐Qiu, He, Kun, Huo, Qin, Yang, Hong‐Hong, Liu, Qian, Chen, Yao‐Kai
• Format: Journal Article
• Language: English
• Published: England Wiley Subscription Services, Inc 01.03.2022; John Wiley and Sons Inc
• Subjects: Anti-HIV Agents - pharmacology; Anti-HIV Agents - therapeutic use; Antiretroviral agents; Antiretroviral therapy; China - epidemiology; Cohort analysis; Drug resistance; Drug Resistance, Viral - genetics; Female; Genotype; Genotypes; HIV; HIV Infections - drug therapy; HIV Infections - epidemiology; HIV‐1; Human immunodeficiency virus; Humans; Mutation; Non-nucleoside reverse transcriptase inhibitors; Nucleoside reverse transcriptase inhibitors; Nucleosides; Original Research; Pretreatment; pretreatment drug resistance; Prevalence; Protease inhibitors; Proteinase inhibitors; Public health; Regression models; Retrospective Studies; Reverse Transcriptase Inhibitors - pharmacology; Risk analysis; Risk factors; RNA-directed DNA polymerase; Snapshot of clinical problems among people living with HIV in China; China; HIV-1; mutation; risk factors; pretreatment drug resistance; genotype
• ISSN: 1464-2662; 1468-1293; 1468-1293
• DOI: 10.1111/hiv.13253

Objectives The emergence of pretreatment drug resistance (PDR) caused by increased usage of antiretroviral therapy (ART) represents a significant challenge to HIV management. In this study, we evaluated the prevalence of PDR in people living with HIV (PLWH) in Chongqing, China. Methods We retrospectively collected the data of 1110 ART‐naïve PLWH in Chongqing from January 1, 2018 to June 30, 2021. HIV‐1 genotypes and drug resistance were analyzed using the HIV‐1 pol sequence. Risk factors associated with PDR were evaluated via the logistic regression model. Results Nine genotypes were detected among 1110 participants, with CRF07_BC (55.68%) being the dominant genotype, followed by CRF01_AE (21.44%), CRF08_BC (14.14%), and other genotypes (8.74%). Of all the participants, 24.14% exhibited drug resistance mutations (DRMs). The predominant DRMs for non‐nucleoside reverse transcriptase inhibitors (NNRTIs) and nucleoside reverse transcriptase inhibitors (NRTIs) were V179D/E/A/DIN (13.60%) and M184V/I (1.44%), respectively, whereas only two major DRMs (M46L and I54L) were identified for protease inhibitors (PIs). The total prevalence of PDR was 10.54%, with 2.43%, 7.66%, and 1.71% participants exhibiting PDR to NRTIs, NNRTIs, and PIs, respectively. Furthermore, female PLWH, delays in ART initiation, and the CRF08_BC genotype were associated with a higher risk of PDR. Conclusions Our study provides the first large cohort data on the prevalence of PDR in Chongqing, China. HIV‐1 genotypes are diverse and complex, with a moderate level of PDR, which does not reach the threshold for the initiation of a public health response. Nevertheless, continuous surveillance of PDR is both useful and advisable.