Author:
Kang Rui-Hua,Liang Shu-Jia,Ma Yan-Ling,Liang Shu,Xiao Lin,Zhang Xin-Hui,Lu Hong-Yan,Xu Xiao-Qin,Luo Shui-Bin,Sun Xiao-Guang,Chen Lin,He Jian-Mei,Wu Guo-Hui,Liao Ling-Jie,Xing Hui,Shao Yi-Ming,Ruan Yu-Hua
Abstract
Abstract
Background
After the scale-up of antiretroviral therapy (ART) for HIV infected people, increasing numbers of patients have pretreatment drug resistance (PDR). In this study, the prevalence of PDR was evaluated in adults initiating antiretroviral therapy in China.
Methods
Blood samples were obtained from 1943 patients who initiated antiretroviral therapy (ART) in 2017 from 13 provinces or cities in China. Pol sequences were used to analyze drug resistance and construct transmission networks. Logistic regression model was used to estimate the potential factors associated with PDR.
Results
In total, 1711 eligible patients (76.0% male; 87.8% aged ≥ 25 years) were included, of which 117 (6.8%) had PDR. The highest rates of PDR were 12.2% in Liangshan Prefecture of Sichuan and 9.3 and 8.9% in Dehong and Lincang Prefecture of Yunnan. A multivariate logistic regression analysis revealed that PDR was significantly higher among intravenous drug users (adjusted Odds Ratio (aOR) = 2.64, 95% CI: 1.57–4.44) and individuals from Liangshan, Dehong, and Lincang (aOR = 2.04, 95% CI: 1.26–3.30). In total, 754 sequences were used to generate 164 transmission networks. Five transmission networks had two or three sequences containing the same mutations, two networks contained subjects from Liangshan, and one network contained subjects from Dehong.
Conclusions
Overall, the PDR prevalence was moderate, with a particularly high prevalence in areas with severe HIV epidemics. These results indicate the importance of continuous PDR monitoring in patients initiating antiretroviral therapy.
Funder
National Natural Science Foundation of China
Ministry of Science and Technology of China
Guangxi Science and Technology Bureau
Publisher
Springer Science and Business Media LLC
Subject
Infectious Diseases,Public Health, Environmental and Occupational Health,General Medicine
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