Background: Widespread use of anti-HIV therapies has led to the global development of drug-resistant HIV strains. In China, our current knowledge of HIV- 1 strain variation, emerging epidemiological trends and viral genetics underlying drug resistance is limited. Method: Between 2008 and 2013, HIV-1 strains from 569 HIV-seropositive and AIDS patients undergoing antiviral treatment in Hebei province (China) were genotyped. ART-virological failure (viral load ≥ 1000 copies/ml) and HIV-1 mutations for these strains were analyzed, as were variations in mutation trends during this period. Results: ART-virological failure in HIV-infected patients decreased significantly between 2008 and 2013 (60.9% vs. 35.0%, p<0.05), and showed a significant decreasing trend (p<0.05). When all HIV-seropositive patients undergoing antiviral treatment were included in this analysis, however, differences or trends observed were not significant. Six mutations were detected in the HIV-1 protease coding region. Only one (A71V/T) showed a significant difference in prevalence during this period (p<0.05). Sixty-one mutations were found in the HIV-1 reverse transcriptase coding region, including 34 related to nucleoside reverse transcriptase inhibitor treatment and 27 related to non-nucleoside reverse transcriptase inhibitor treatment. Thirteen mutations (V75I, T215Y, M41L, L210W, T69D, D67DG, V118I, V75I/T, F77L, T215F, Q151M; NNRTI-related: V108I, M230L) exhibited significant decreasing trends between 2010 and 2013, and two mutations (K238T, V90I) showed significant increasing trends (p<0.05). Conclusion: Continuous monitoring of drug resistance is essential for the design of optimal regimens and improvement of therapeutic outcomes.
Hongru Zhao, Xinli Lu, Wei Wang, Cuiying Zhao, Yuqi Zhang, Guangyi Bai, Yan Li, Yingying Wang