scholarly journals Prevalence and determinants of virological failure, genetic diversity and drug resistance among people living with HIV in a minority area in China: a population-based study

2020 ◽  
Author(s):  
Dan Yuan ◽  
Meijing Liu ◽  
Peng Jia ◽  
Yiping Li ◽  
Yuling Huang ◽  
...  
Keyword(s):  
Genetic Diversity ◽  
Drug Resistance ◽  
Virological Failure ◽  
Illicit Drugs ◽  
Clinical Stage ◽  
Venous Blood ◽  
Hiv Treatment ◽  
People Living With Hiv ◽  
Living With Hiv ◽  
Hiv 1

Abstract Background Liangshan Yi Autonomous Prefecture is one of the areas that most severely affected by human immunodeficiency virus (HIV) in China, and virological failure on antiretroviral therapy (ART) is serious in this area. Analyses of prevalence and determinants of ART failure, the genetic diversity and drug resistance among people living with HIV (PLWH) helps improve HIV treatment efficiency and prevent HIV transmission. Methods A total of 5157 PLWH were recruited from 2016 to 2017. The venous blood samples were subjected to RT-PCR, followed by sequencing of the HIV-1 pol gene, targeting the protease and reverse transcriptase fragments. HIV-1 diversity was analyzed using the DNAStar software and drug resistance mutations were analyzed using the Stanford University HIV Drug Resistance Database. Results A total of 2156 (41.81%) PLWH showed virological failure on ART. Males (ORm=1.25), heterosexual behaviors and drug injection (ORm=1.44) and mother to child transmission routes (ORm=1.58), the clinical stage of AIDS (ORm=1.35), having used illicit drugs and shared the needles (1-4 times: ORm=1.34; more than 5 times: ORm=1.52), having ever replaced ART regimen (ORm=1.48) increased the risk of virological failure among PLWH, while higher education lever (ORm=0.77) and ≥12 months on ART (12~36 months: ORm=0.72; ≥36 months: ORm=0.66) was associated with lower likelihood of virological failure. The data revealed that CRF07_BC (1508, 95.62%) were the most common strains, and the drug-resistant rate was 32.10% among PLWH with virological failure in this area. The high frequencies of drug resistance were found in EFV and NVP of NNRTIs, ABC, FTC and 3TC of NRTIs, and TPV/r in PIs. The most common mutations in NNRTIs, NRTIs and PIs were K103N/KN (64.69%), M184V/MV/I (36.29%) and Q58E/QE (4.93%), respectively. Conclusion We concluded that surveillance of virological failure, HIV-1 subtypes, and drug resistance to understand HIV-1 epidemiology and guide modification of ART guidelines, and target prevention and control strategies should be formatted to reduce the virological failure and drug resistance to promote viral suppression and prevent HIV-1 transmission.

scholarly journals Prevalence and determinants of virological failure, genetic diversity and drug resistance among people living with HIV in a minority area in China: a population-based study

2020 ◽  
Author(s):  
Dan Yuan ◽  
Meijing Liu ◽  
Peng Jia ◽  
Yiping Li ◽  
Yuling Huang ◽  
...  
Keyword(s):  
Genetic Diversity ◽  
Drug Resistance ◽  
Virological Failure ◽  
Illicit Drugs ◽  
Clinical Stage ◽  
Venous Blood ◽  
Hiv Treatment ◽  
People Living With Hiv ◽  
Living With Hiv ◽  
Hiv 1

Abstract Background: Liangshan Yi Autonomous Prefecture is one of the areas that most severely affected by human immunodeficiency virus (HIV) in China, and virological failure on antiretroviral therapy (ART) is serious in this area. Analyses of prevalence and determinants of ART failure, the genetic diversity and drug resistance among people living with HIV (PLWH) helps improve HIV treatment efficiency and prevent HIV transmission.Methods: A total of 5157 PLWH were recruited from 2016 to 2017. The venous blood samples were subjected to RT-PCR, followed by sequencing of the HIV-1 pol gene, targeting the protease and reverse transcriptase fragments. HIV-1 diversity was analyzed using the DNAStar software and drug resistance mutations were analyzed using the Stanford University HIV Drug Resistance Database.Results: A total of 2156 (41.81%) PLWH showed virological failure on ART. Males (ORm=1.25), heterosexual behaviors and drug injection (ORm=1.44) and mother to child transmission routes (ORm=1.58), the clinical stage of AIDS (ORm=1.35), having used illicit drugs and shared the needles (1-4 times: ORm=1.34; more than 5 times: ORm=1.52), having ever replaced ART regimen (ORm=1.48) increased the risk of virological failure among PLWH, while higher education lever (ORm=0.77) and ≥12 months on ART (12~36 months: ORm=0.72; ≥36 months: ORm=0.66) was associated with lower likelihood of virological failure. The data revealed that CRF07_BC (1508, 95.62%) were the most common strains, and the drug-resistant rate was 32.10% among PLWH with virological failure in this area. The high frequencies of drug resistance were found in EFV and NVP of NNRTIs, ABC, FTC and 3TC of NRTIs, and TPV/r in PIs. The most common mutations in NNRTIs, NRTIs and PIs were K103N/KN (64.69%), M184V/MV/I (36.29%) and Q58E/QE (4.93%), respectively.Conclusion: We concluded that surveillance of virological failure, HIV-1 subtypes, and drug resistance to understand HIV-1 epidemiology and guide modification of ART guidelines, and target prevention and control strategies should be formatted to reduce the virological failure and drug resistance to promote viral suppression and prevent HIV-1 transmission.

scholarly journals HIV-1 drug resistance and genetic diversity in a cohort of people living with HIV-1 in Nigeria

AIDS ◽  
2021 ◽  
Vol Publish Ahead of Print ◽  
Author(s):  
Paul E. Oluniyi ◽  
Fehintola V. Ajogbasile ◽  
Shuntai Zhou ◽  
Iyanuoluwa Fred-Akintunwa ◽  
Christina S. Polyak ◽  
...  
Keyword(s):  
Genetic Diversity ◽  
Drug Resistance ◽  
People Living With Hiv ◽  
Living With Hiv ◽  
Hiv 1

scholarly journals Nationwide Study of Drug Resistance Mutations in HIV-1 Infected Individuals under Antiretroviral Therapy in Brazil

2021 ◽  
Vol 22 (10) ◽  
pp. 5304
Author(s):  
Ana Santos-Pereira ◽  
Vera Triunfante ◽  
Pedro M. M. Araújo ◽  
Joana Martins ◽  
Helena Soares ◽  
...  
Keyword(s):  
Drug Resistance ◽  
People Living With Hiv ◽  
Resistance Mutations ◽  
Subtype C ◽  
Viral Loads ◽  
Drug Resistance Mutations ◽  
Subtype B ◽  
Low Prevalence ◽  
Living With Hiv ◽  
Hiv 1

The success of antiretroviral treatment (ART) is threatened by the emergence of drug resistance mutations (DRM). Since Brazil presents the largest number of people living with HIV (PLWH) in South America we aimed at understanding the dynamics of DRM in this country. We analyzed a total of 20,226 HIV-1 sequences collected from PLWH undergoing ART between 2008–2017. Results show a mild decline of DRM over the years but an increase of the K65R reverse transcriptase mutation from 2.23% to 12.11%. This increase gradually occurred following alterations in the ART regimens replacing zidovudine (AZT) with tenofovir (TDF). PLWH harboring the K65R had significantly higher viral loads than those without this mutation (p < 0.001). Among the two most prevalent HIV-1 subtypes (B and C) there was a significant (p < 0.001) association of K65R with subtype C (11.26%) when compared with subtype B (9.27%). Nonetheless, evidence for K65R transmission in Brazil was found both for C and B subtypes. Additionally, artificial neural network-based immunoinformatic predictions suggest that K65R could enhance viral recognition by HLA-B27 that has relatively low prevalence in the Brazilian population. Overall, the results suggest that tenofovir-based regimens need to be carefully monitored particularly in settings with subtype C and specific HLA profiles.

scholarly journals Intermittent HIV-1 Viremia (Blips) and Virological Failure in a Cohort of People Living with HIV from São Paulo, Brazil

2012 ◽  
Vol 26 (9) ◽  
pp. 512-515 ◽  
Author(s):  
Karim Yaqub Ibrahim ◽  
Patricia Recordon-Pinson ◽  
Denis Malvy ◽  
Hervé Fleury ◽  
Aluisio Cotrim Segurado
Keyword(s):  
Virological Failure ◽  
Sao Paulo ◽  
People Living With Hiv ◽  
São Paulo ◽  
Living With Hiv ◽  
Hiv 1

scholarly journals Prevalence and Molecular Epidemiology of Transmitted Drug Resistance and Genetic Transmission Networks Among Newly Diagnosed People Living With HIV/AIDS in a Minority Area, China

2021 ◽  
Vol 9 ◽  
Author(s):  
Dan Yuan ◽  
Bin Yu ◽  
Yiping Li ◽  
Zixin Wang ◽  
Meijing Liu ◽  
...  
Keyword(s):  
Drug Resistance ◽  
Molecular Epidemiology ◽  
Transmitted Drug Resistance ◽  
People Living With Hiv ◽  
Newly Diagnosed ◽  
Transmission Networks ◽  
Genetic Transmission ◽  
Living With Hiv ◽  
Hiv 1 ◽  
Minority Area

Introduction: Transmitted drug resistance (TDR) can compromise antiretroviral therapy (ART) efficacy. We aimed to understand the molecular epidemiology of TDR and its genetic transmission networks among newly diagnosed people living with HIV/AIDS (PLWH).Methods: A total of 1,318 newly diagnosed PLWH, identified in all population-based HIV screening in an HIV-affected county of a minority area of China (i.e., Butuo county), were enrolled between January 1, 2018, and November 31, 2018. HIV-1 pol gene sequences were used for phylogenetic and genotypic drug resistance analyses. The genetic transmission networks were identified.Results: The prevalence of TDR among newly diagnosed PLWH was 8.12% (107/1,318). Patients in the stage of AIDS (adjusted odds ratio, OR: 2.32) and who had a history of sharing a needle ≥5 times (adjusted OR: 3.89) were more likely to have an increased risk of TDR. The prevalence of TDR for non-nucleoside reverse transcriptase inhibitors (NNRTIs) is higher than that of other inhibitors, with a relatively high prevalence of three mutations [V179D/E/DE (4.93%), K103N/KN (3.11%), and E138A/G (1.52%)]. A total of 577 (43.78%) pol sequences were involved in the genetic transmission network, with 171 clusters ranging in size from 2 to 91 pol sequences; 37.38% (40/107) of individuals carrying TDR were involved in the network, and individuals with the same TDR-associated mutations were usually cross-linked.Conclusions: Our data suggest a relatively high level of TDR and many transmission clusters among the newly diagnosed PLWH. Targeted intervention, early identification, and monitoring of resistance are warranted to reduce the TDR and prevent HIV-1 transmission in areas with a high rate of HIV-1.

scholarly journals Viral load as a risk factor of reverse transcriptase inhibitor drug resistance mutation in antiretroviral-treated people living with HIV/AIDS

2021 ◽  
Vol 40 (3) ◽  
pp. 243-253
Author(s):  
Hotma Martogi Lorensi Hutapea ◽  
Tri Nury Kridaningsih ◽  
Khoirul Huda Prasetyo ◽  
Milton Boaheng Antwi
Keyword(s):  
Drug Resistance ◽  
Logistic Regression ◽  
Viral Load ◽  
Reverse Transcriptase ◽  
Cd4 Count ◽  
People Living With Hiv ◽  
Multiple Logistic Regression ◽  
Living With Hiv ◽  
Hiv 1 ◽  
Hiv Aids

Background The human immunodeficiency virus type 1 (HIV-1) is a major contagion faced by the population of Indonesia. The success of antiretroviral treatment (ART) is threatened by the emergence of drug resistance mutations (DRM). The aim of this study was to determine the association between CD4 count, CD4 count changes, viral load, adherence to therapy, and therapy history in the presence of DRM in people living with HIV/AIDS (PLWHA). MethodsThis was a cross-sectional study involving 269 adults who underwent antiretroviral (ARV) therapy for at least 6 months. The frequencies of DRM and polymorphisms were measured by partial amplification of the reverse transcriptase (RT) gene using RT-nested PCR on samples with viral loads of >1000 copies/mL. Sequencing was performed using the Sanger method, and edited by BioEdit. The edited sequences were submitted to http://hivdb.stanford.edu for DRM determination. Respondents’ medical data, CD4 count, viral load, and DRM were analyzed by simple and multiple logistic regression. ResultsThe multiple logistic regression analysis showed a significant association of CD4 count (aOR=12.47; 95% CI: 1.45 -107.39; p=0.023) and viral load at the time of study (aOR=29.56; 95% CI: 3.47-251.52; p=0.002) with the presence of DRM in respondents. ARV substitution history was not associated with the presence of DRM. There were 17 respondents (6.3%) carrying HIV-1 DRM, with M184V/I (11 sequences) as the most frequent pattern of NRTI resistance, and K103 (9 sequences) as that of NNRTI resistance. ConclusionThis study demonstrated that viral load at the time of the study was the most influential determinant factor for the presence of DRM in PLWHA.

scholarly journals Virological and Immunological Status of the People Living with HIV/AIDS Undergoing ART Treatment in Nepal

2016 ◽  
Vol 2016 ◽  
pp. 1-7 ◽  
Author(s):  
Chet Raj Ojha ◽  
Geeta Shakya ◽  
Shyam Prakash Dumre
Keyword(s):  
Viral Load ◽  
Virological Failure ◽  
Care Center ◽  
Tertiary Care ◽  
People Living With Hiv ◽  
Cell Counts ◽  
The People ◽  
Route Of Transmission ◽  
Living With Hiv ◽  
Hiv 1

Antiretroviral therapy (ART) has increased the life span of the people living with HIV (PLHIV), but their virological and immunological outcomes are not well documented in Nepal. The study was conducted at a tertiary care center including 826 HIV-1 seropositive individuals undergoing ART for at least six months. Plasma viral load (HIV-1 RNA) was detected by Real Time PCR and CD4+T-lymphocyte (CD4+) counts were estimated by flow cytometry. The mean CD4+count of patients was 501 (95% CI = 325–579) cells/cumm, but about 35% of patients had CD4+T cell counts below 350 cells/cumm. With increasing age, average CD4+count was found to be decreasing (p=0.005). Of the total cases, 82 (9.92%) were found to have virological failure (viral load: >1000 copies/ml). Tenofovir/Lamivudine/Efavirenz (TDF/3TC/EFV), the frequently used ART regimen in Nepal, showed virological failure in 11.34% and immunological failure in 37.17% of patients. Virological failure rate was higher among children < 15 years (14.5%) (p=0.03); however, no association was observed between ART outcomes and gender or route of transmission. The study suggests there are still some chances of virological and immunological failures despite the success of highly active ART (HAART).

scholarly journals Transmitted Drug Resistance among People Living with HIV/Aids at Major Cities of Sao Paulo State, Brazil

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Joao Leandro Paula Ferreira ◽  
Rosangela Rodrigues ◽  
Andre Minhoto Lança ◽  
Valeria Correia de Almeida ◽  
Simone Queiroz Rocha ◽  
...  
Keyword(s):  
Drug Resistance ◽  
Resistance Mutation ◽  
Treatment Guideline ◽  
Sao Paulo ◽  
Hiv Treatment ◽  
Public Health Issue ◽  
Transmitted Drug Resistance ◽  
People Living With Hiv ◽  
São Paulo ◽  
Hiv 1

Human immunodeficiency virus type 1 (HIV-1) transmitted drug resistance (TDR) is an important public health issue. In Brazil, low to intermediate resistance levels have been described. We assessed 225 HIV-1 infected, antiretroviral naïve individuals, from HIV Reference Centers at two major metropolitan areas of Sao Paulo (Sao Paulo and Campinas), the state that concentrates most of the Brazilian Aids cases. TDR was analyzed by Stanford Calibrated Population Resistance criteria (CPR), and mutations were observed in 17 individuals (7.6%, 95% CI: 4.5%–11.9%). Seventy-six percent of genomes (13/17) with TDR carried a nonnucleoside reverse transcriptase inhibitor (NNRTI) resistance mutation, mostly K103N/S (9/13, 69%), potentially compromising the preferential first-line therapy suggested by the Brazilian HIV Treatment Guideline that recommends efavirenz-based combinations. Moreover, 6/17 (35%) had multiple mutations associated with resistance to one or more classes. HIV-1 B was the prevalent subtype (80%); other subtypes include HIV-1 F and C, mosaics BC, BF, and single cases of subtype A1 and CRF02_AG. The HIV Reference Center of Campinas presented more cases with TDR, with a significant association of TDR with clade B infection (P<0.05).

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