Abstract

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.