Original Article
Analysis of drug resistance in patients with acquired immunodeficiency syndrome who failed antiviral therapy
Chen Zhaoyun, Sun Yan, Li Chaofeng, Liu Chunli, Yang Xuan, Zhang Xue, Chen Yuanyuan, Cai Yan, Cao Kun, Zhao Qingxia
Published 2021-08-15
Cite as Chin J Infect Dis, 2021, 39(8): 480-484. DOI: 10.3760/cma.j.cn311365-20200925-00797
Abstract
ObjectiveTo investigate the drug resistance of patients with acquired immunodeficiency syndrome (AIDS) who failed antiviral therapy.
MethodsA total of 156 AIDS patients with antiviral therapy failure at the Sixth People′s Hospital of Zhengzhou from October 2017 to December 2018 were selected. The human immunodeficiency virus (HIV)-1 ViroSeq™ genotyping method was used for the detection of HIV resistance, and Stanford University HIV drug resistance database (http: ∥hivdb.stanford.edu/) was used for testing results comparison.
ResultsAmong the 156 AIDS patients with antiviral therapy failure, 122(78.21%) developed drug resistance. One hundred and six (67.95%) cases were multi-resistant to nucleoside reverse transcriptase inhibitor (NRTI), among which, 104 (66.67%) were resistant to lamivudine, emtricitabine and abacavir. One hundred and eighteen (75.64%) were resistant to non-nucleoside reverse transcriptase inhibitor (NNRTI), and 118 (75.64%) were multi-resistant to efavirenz and nevirapine. And seven (4.49%) were resistant to protease inhibitor (PI). There were 16 resistant sites for NRTI, with 87 (71.31%) most frequent M184V/I mutations. There were 13 resistant sites for NNRTI, with 49 (40.16%) K103N/R mutations. There were 11 resistant sites for PI, with 49 (40.16%) A71V/T mutations. The antiviral drugs lamivudine and emtricitabine were moderately and highly resistant in 102 (83.61%) cases, efavirenz and nevirapine were moderately and highly resistant in 117 (95.90%) cases. Once drug resistance developed, these drugs were likely to be moderate or high resistance. There were 29 (23.77%), 48 (39.34%), and five (4.10%) cases were resistant to zidovudine, tenofovir and lopinavir/ritonavir, respectively. The resistance barrier of these drugs was relatively high.
ConclusionThe incidence of drug resistance in patients with AIDS treatment failure is high, and multi-drug resistance is serious with various sites of drug resistance.
Key words:
Acquired immunodeficiency syndrome; Drug resistance; Antiretroviral treatment
Contributor Information
Chen Zhaoyun
Department of Infectious Diseases, The Sixth People′s Hospital of Zhengzhou, Zhengzhou 450015, China
Sun Yan
Department of Infectious Diseases, The Sixth People′s Hospital of Zhengzhou, Zhengzhou 450015, China
Li Chaofeng
Department of Infectious Diseases, The Sixth People′s Hospital of Zhengzhou, Zhengzhou 450015, China
Liu Chunli
Department of Infectious Diseases, The Sixth People′s Hospital of Zhengzhou, Zhengzhou 450015, China
Yang Xuan
Department of Infectious Diseases, The Sixth People′s Hospital of Zhengzhou, Zhengzhou 450015, China
Zhang Xue
Department of Infectious Diseases, The Sixth People′s Hospital of Zhengzhou, Zhengzhou 450015, China
Chen Yuanyuan
Department of Infectious Diseases, The Sixth People′s Hospital of Zhengzhou, Zhengzhou 450015, China
Cai Yan
Department of Infectious Diseases, The Sixth People′s Hospital of Zhengzhou, Zhengzhou 450015, China
Cao Kun
Department of Infectious Diseases, The Sixth People′s Hospital of Zhengzhou, Zhengzhou 450015, China
Zhao Qingxia
Department of Infectious Diseases, The Sixth People′s Hospital of Zhengzhou, Zhengzhou 450015, China
