Pretreatment HIV drug resistance in adults initiating antiretroviral therapy in China, 2017.

Autor: Kang RH; State Key Laboratory of Infectious Disease Prevention and Control (SKLID), National Center for AIDS/STD Control and Prevention (NCAIDS), Chinese Center for Disease Control and Prevention (China CDC), Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, 155 Changbai Road, Changping District, Beijing, PR China., Liang SJ; Guangxi Center for Disease Control and Prevention, Nanning, Guangxi, China., Ma YL; Yunnan Center for Disease Control and Prevention, Kunming, Yunnan, China., Liang S; Sichuan Center for Disease Control and Prevention, Chengdu, Sichuan, China., Xiao L; Liangshan Center for Disease Control and Prevention, Liangshan prefecture, Sichuan, China., Zhang XH; Guizhou Center for Disease Control and Prevention, Guiyang, Guizhou, China., Lu HY; Beijing Center for Disease Control and Prevention, Beijing, China., Xu XQ; Jiangsu Center for Disease Control and Prevention, Nanjing, Jiangsu, China., Luo SB; Neijiang Center for Disease Control and Prevention, Neijiang, Sichuan, China., Sun XG; Shandong Center for Disease Control and Prevention, Jinan, Shandong, China., Chen L; Shenzhen Center for Disease Control and Prevention, Shenzhen, Guangdong, China., He JM; Hunan Center for Disease Control and Prevention, Changsha, Hunan, China., Wu GH; Chongqing Center for Disease Control and Prevention, Chongqing, China., Liao LJ; State Key Laboratory of Infectious Disease Prevention and Control (SKLID), National Center for AIDS/STD Control and Prevention (NCAIDS), Chinese Center for Disease Control and Prevention (China CDC), Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, 155 Changbai Road, Changping District, Beijing, PR China.; Guangxi Center for Disease Control and Prevention, Nanning, Guangxi, China., Xing H; State Key Laboratory of Infectious Disease Prevention and Control (SKLID), National Center for AIDS/STD Control and Prevention (NCAIDS), Chinese Center for Disease Control and Prevention (China CDC), Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, 155 Changbai Road, Changping District, Beijing, PR China.; Guangxi Center for Disease Control and Prevention, Nanning, Guangxi, China., Shao YM; State Key Laboratory of Infectious Disease Prevention and Control (SKLID), National Center for AIDS/STD Control and Prevention (NCAIDS), Chinese Center for Disease Control and Prevention (China CDC), Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, 155 Changbai Road, Changping District, Beijing, PR China. yshao@bjmu.edu.cn.; Guangxi Center for Disease Control and Prevention, Nanning, Guangxi, China. yshao@bjmu.edu.cn., Ruan YH; State Key Laboratory of Infectious Disease Prevention and Control (SKLID), National Center for AIDS/STD Control and Prevention (NCAIDS), Chinese Center for Disease Control and Prevention (China CDC), Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, 155 Changbai Road, Changping District, Beijing, PR China. ruanyuhua92@163.com.
Jazyk: angličtina
Zdroj: Infectious diseases of poverty [Infect Dis Poverty] 2020 May 24; Vol. 9 (1), pp. 54. Date of Electronic Publication: 2020 May 24.
DOI: 10.1186/s40249-020-00668-5
Abstrakt: 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.
Databáze: MEDLINE
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