Abstract：
To assess the profiles and determinants of drug resistance in HIV-1-infected individuals undergoing ART in Guangxi.
Samples and data were collected from HIV-1-infected individuals experiencing virological failure post-ART from 14 cities in Guangxi. Sequencing of the HIV-1 pol gene was conducted, followed by analysis for drug resistance mutations using the Stanford University HIV Drug Resistance Database. Logistic regression was employed to identify potential risk factors associated with both HIV drug resistance and mortality.
A total of 8963 individuals with pol sequences were included in this study. The overall prevalence of HIV-1 drug resistance (HIVDR) was 42.43% (3808/8963), showing a decrease from 59.62% to 41.40% from 2016 to 2023. Factors such as being aged ≥50 years, male, Han nationality, lower education levels, occupations including workers, peasants and children, AIDS, pre-treatment CD4 T cell counts <200 cells/mm3, infection with CRF01_AE and CRF55_01B subtypes, and ART regimen lamivudine/zidovudine/nevirapine were associated with higher susceptibility to HIVDR. The common mutations were M184V (17.38%) and K103N (22.14%). Additionally, the prevalence of M184V, S68G, M41L and G190A were different between the Han and Zhuang populations. Factors including age, gender, ethnicity, education level, occupation, infectious route, clinical stage, viral load, subtype, ART regimen and HIVDR showed significant associations with mortality.
The factors contributing to drug resistance in the HIV-1 ART individuals in Guangxi appear to be notably intricate. Continuous reinforcement of drug resistance surveillance is imperative, accompanied by the optimization of ART regimens to mitigate virological failures effectively.
Samples and data were collected from HIV-1-infected individuals experiencing virological failure post-ART from 14 cities in Guangxi. Sequencing of the HIV-1 pol gene was conducted, followed by analysis for drug resistance mutations using the Stanford University HIV Drug Resistance Database. Logistic regression was employed to identify potential risk factors associated with both HIV drug resistance and mortality.
A total of 8963 individuals with pol sequences were included in this study. The overall prevalence of HIV-1 drug resistance (HIVDR) was 42.43% (3808/8963), showing a decrease from 59.62% to 41.40% from 2016 to 2023. Factors such as being aged ≥50 years, male, Han nationality, lower education levels, occupations including workers, peasants and children, AIDS, pre-treatment CD4 T cell counts <200 cells/mm3, infection with CRF01_AE and CRF55_01B subtypes, and ART regimen lamivudine/zidovudine/nevirapine were associated with higher susceptibility to HIVDR. The common mutations were M184V (17.38%) and K103N (22.14%). Additionally, the prevalence of M184V, S68G, M41L and G190A were different between the Han and Zhuang populations. Factors including age, gender, ethnicity, education level, occupation, infectious route, clinical stage, viral load, subtype, ART regimen and HIVDR showed significant associations with mortality.
The factors contributing to drug resistance in the HIV-1 ART individuals in Guangxi appear to be notably intricate. Continuous reinforcement of drug resistance surveillance is imperative, accompanied by the optimization of ART regimens to mitigate virological failures effectively.
摘要：
目的：评估广西接受ART治疗的HIV-1感染者的耐药性概况和决定因素。
方法：样本和数据来自广西14个城市的HIV-1感染者，在ART后经历病毒学失败。对HIV-1pol基因进行测序，然后使用斯坦福大学HIV耐药数据库分析耐药突变.采用Logistic回归分析确定与HIV耐药和死亡率相关的潜在危险因素。
结果:本研究包括总共8963个具有pol序列的个体。HIV-1耐药(HIVDR)的总体患病率为42.43%(3808/8963),显示从2016年至2023年的59.62%下降至41.40%。年龄≥50岁等因素，男性,汉族,教育水平较低,包括工人在内的职业，农民和儿童，艾滋病,治疗前CD4T细胞计数<200细胞/mm3，感染CRF01_AE和CRF55_01B亚型，和ART方案拉米夫定/齐多夫定/奈韦拉平对HIVDR的易感性更高。常见突变为M184V(17.38%)和K103N(22.14%)。此外,M184V的患病率，S68G,M41L和G190A在汉族和壮族之间存在差异。因素包括年龄,性别,种族,教育水平,职业,感染途径,临床分期,病毒载量,子类型,ART方案和HIVDR显示与死亡率显著相关。
结论：导致广西HIV-1ART个体耐药的因素似乎非常复杂。持续加强耐药性监测势在必行,伴随着ART方案的优化，以有效地减轻病毒学故障。
方法：样本和数据来自广西14个城市的HIV-1感染者，在ART后经历病毒学失败。对HIV-1pol基因进行测序，然后使用斯坦福大学HIV耐药数据库分析耐药突变.采用Logistic回归分析确定与HIV耐药和死亡率相关的潜在危险因素。
结果:本研究包括总共8963个具有pol序列的个体。HIV-1耐药(HIVDR)的总体患病率为42.43%(3808/8963),显示从2016年至2023年的59.62%下降至41.40%。年龄≥50岁等因素，男性,汉族,教育水平较低,包括工人在内的职业，农民和儿童，艾滋病,治疗前CD4T细胞计数<200细胞/mm3，感染CRF01_AE和CRF55_01B亚型，和ART方案拉米夫定/齐多夫定/奈韦拉平对HIVDR的易感性更高。常见突变为M184V(17.38%)和K103N(22.14%)。此外,M184V的患病率，S68G,M41L和G190A在汉族和壮族之间存在差异。因素包括年龄,性别,种族,教育水平,职业,感染途径,临床分期,病毒载量,子类型,ART方案和HIVDR显示与死亡率显著相关。
结论：导致广西HIV-1ART个体耐药的因素似乎非常复杂。持续加强耐药性监测势在必行,伴随着ART方案的优化，以有效地减轻病毒学故障。
