On page 233 and 235,volume 5 of Infectious Diseases&Immunity,in the article“Characteristics and risk factors of acquired drug resistance among people living with HIV:A retrospective study in Guangzhou,China(2018-...On page 233 and 235,volume 5 of Infectious Diseases&Immunity,in the article“Characteristics and risk factors of acquired drug resistance among people living with HIV:A retrospective study in Guangzhou,China(2018-2023)”,[1]there is an error regarding the ART regimen classification in Table 1,Table 2,and section 3.4.The regimen category labeled as“2NNRTI”should be corrected to“2NRTI”throughout.展开更多
Background:Acquired drug resistance(ADR)in people living with HIV(PLWH)reduces treatment efficacy,restricts drug options,and increases the risk of human immunodeficiency virus(HIV)transmission.The resistance character...Background:Acquired drug resistance(ADR)in people living with HIV(PLWH)reduces treatment efficacy,restricts drug options,and increases the risk of human immunodeficiency virus(HIV)transmission.The resistance characteristics and associated risk factors of PLWH suffering from virological failure(VF)in Guangdong remain unclear,thus highlighting the need for further research in this area.This retrospective study examines the prevalence,resistance characteristics,and contributing factors of ADR among PLWH who experienced VF in Guangzhou,China,between 2018 and 2023.Methods:Blood samples,epidemiological and demographic data were collected from PLWH with VF at Guangzhou Eight People’s Hospital in Guangzhou,China,between January 1,2018 and December 1,2023.ADR was analyzed through HIV pol sequences,with drug resistance mutations(DRMs)identified using the Stanford University HIV Drug Resistance Database.A 1:1 matched group of virologically suppressed(VS)patients was randomly selected using the“sample”function in R from those who maintained VS during the same study period to facilitate the study’s analysis of ADR-associated factors,which were chosen based on clinical relevance,previous studies,and data availability,and identified through logistic regression models.Results:A total of 1592 patients experienced VF during the study period,with 959 having protease/reverse transcriptase sequences and 479 having integrase sequences.DRMs were identified in 60.2%(577/959)of the patients,with an overall ADR prevalence of 46.1%(442/959).The resistance rates for specific drug classes were as follows:nucleotide reverse transcriptase inhibitors(NRTIs)at 33.3%(319/959),non-nucleoside reverse transcriptase inhibitors(NNRTIs)at 36.8%(353/959),protease inhibitors at 3.3%(32/959),and integrase strand transfer inhibitors(INSTIs)at 1.5%(7/479).The multivariable logistic regression analysis revealed several factors linked to a higher risk of ADR,including World Health Organization clinical stages III and IV,baseline CD4+T cell counts<200 cells/mm3,and relatively more antiretroviral therapy regimen changes.Conversely,patients who were on 2NRTI+INSTI regimens and experienced heterosexual transmission were at relatively lower risk of ADR.Conclusion:The prevalence of ADR in Guangzhou was primarily driven by NNRTI resistance.The choice and use of treatment regimens are closely linked to ADR occurrence,and minimizing unnecessary regimen changes may help significantly lower ADR risk.展开更多
Background:With the high prevalence of pre-treatment drug resistance(PDR)and the potential impact to the virological inhibition,the detection of PDR was particularly necessary.This study aimed to determine the prevale...Background:With the high prevalence of pre-treatment drug resistance(PDR)and the potential impact to the virological inhibition,the detection of PDR was particularly necessary.This study aimed to determine the prevalence of PDR in Guangdong,China,and its impact on antiretroviral therapy(ART)in treatment-naive HIV patients.Methods:A retrospective cohort study was conducted.A total of 1936 HIV-1-infected treatment-naive patients in the clinic of the infectious department,Guangzhou Eighth People’s Hospital,between August 2018 and December 2019 were assayed for PDR mutations before initiating ART.Patients with PDR mutations(PDR arm)were screened and compared with those without drug-resistant mutations(non-PDR arm).The rate of HIV-1 virologic failure(VF)and CD4^(+)T-cell counts of the 2 arms were compared at the 96th week after ART to evaluate the impact of PDR on the efficacy of ART.Results:Pretreatment drug resistance was detected in 125 cases(6.46%)from the 1936 enrolled participants,most of which were resistant to non-nucleoside reverse transcriptase inhibitors(64.00%,80/125).One hundred and eight of 125 completed the follow-up of 96 weeks(PDR arm).In this cohort,52 patients whose ART regimen containing the resistant drug were grouped as con-PDR arm,and the remaining 56 patients whose ART regimen did not contain the resistant drug were grouped as non-con-PDR arm.A total of 125 patients without PDR were randomly selected as the control group(non-PDR arm),112 of whom had completed the 96-week followup.At the 96th week after ART initiation,7 patients(6.5%,7/108)in the PDR arm and 1 patient(0.9%,1/112)in the non-PDR arm developed VF,exhibiting a significant difference(χ^(2)=4.901,P=0.029).Meanwhile,3 patients(5.8%,3/52)in the con-PDR arm developed VF;the rate was also higher than that in the non-PDR arm,but without a significant difference(χ^(2)=3.549,P=0.095).The CD4^(+)T-cell count in the non-PDR arm increased more than the PDR arm(386.6 vs.319.1 cells/μL,t=2.448,P=0.015)or the con-PDRarm(386.6 vs.325.1 cells/μL,t=1.821,P=0.070)at 12weeks afterART.However,no significant differenceswere observed in the CD4^(+)T-cell count from the 24th week after ART onward.Conclusions:Pretreatment drug resistance was moderately prevalent in Guangdong,China,and could affect the antiretroviral efficacy during a 96-week observation period,indicating the need to closely monitor PDR before ART initiation.展开更多
文摘On page 233 and 235,volume 5 of Infectious Diseases&Immunity,in the article“Characteristics and risk factors of acquired drug resistance among people living with HIV:A retrospective study in Guangzhou,China(2018-2023)”,[1]there is an error regarding the ART regimen classification in Table 1,Table 2,and section 3.4.The regimen category labeled as“2NNRTI”should be corrected to“2NRTI”throughout.
基金supported by the Science and Technology Project of Guangzhou(2024A03J0878,2024A03J0879,2023A03J0801,2024A03J0883)Medical Key Discipline Program of Guangzhou-Infectious Diseases(2025-2027).
文摘Background:Acquired drug resistance(ADR)in people living with HIV(PLWH)reduces treatment efficacy,restricts drug options,and increases the risk of human immunodeficiency virus(HIV)transmission.The resistance characteristics and associated risk factors of PLWH suffering from virological failure(VF)in Guangdong remain unclear,thus highlighting the need for further research in this area.This retrospective study examines the prevalence,resistance characteristics,and contributing factors of ADR among PLWH who experienced VF in Guangzhou,China,between 2018 and 2023.Methods:Blood samples,epidemiological and demographic data were collected from PLWH with VF at Guangzhou Eight People’s Hospital in Guangzhou,China,between January 1,2018 and December 1,2023.ADR was analyzed through HIV pol sequences,with drug resistance mutations(DRMs)identified using the Stanford University HIV Drug Resistance Database.A 1:1 matched group of virologically suppressed(VS)patients was randomly selected using the“sample”function in R from those who maintained VS during the same study period to facilitate the study’s analysis of ADR-associated factors,which were chosen based on clinical relevance,previous studies,and data availability,and identified through logistic regression models.Results:A total of 1592 patients experienced VF during the study period,with 959 having protease/reverse transcriptase sequences and 479 having integrase sequences.DRMs were identified in 60.2%(577/959)of the patients,with an overall ADR prevalence of 46.1%(442/959).The resistance rates for specific drug classes were as follows:nucleotide reverse transcriptase inhibitors(NRTIs)at 33.3%(319/959),non-nucleoside reverse transcriptase inhibitors(NNRTIs)at 36.8%(353/959),protease inhibitors at 3.3%(32/959),and integrase strand transfer inhibitors(INSTIs)at 1.5%(7/479).The multivariable logistic regression analysis revealed several factors linked to a higher risk of ADR,including World Health Organization clinical stages III and IV,baseline CD4+T cell counts<200 cells/mm3,and relatively more antiretroviral therapy regimen changes.Conversely,patients who were on 2NRTI+INSTI regimens and experienced heterosexual transmission were at relatively lower risk of ADR.Conclusion:The prevalence of ADR in Guangzhou was primarily driven by NNRTI resistance.The choice and use of treatment regimens are closely linked to ADR occurrence,and minimizing unnecessary regimen changes may help significantly lower ADR risk.
基金supported by the Major National Science and Technology Projects during the 13th 5-year plan period(2017ZX10202101-003,2017ZX10202102-003-004)the Guangzhou Science and Technology Innovation Committee project(new strategy for functional cure of AIDS–clinical and basic research,201803040002)Guangzhou basic research program on people’s Livelihood Science and technology(No.202002020005).
文摘Background:With the high prevalence of pre-treatment drug resistance(PDR)and the potential impact to the virological inhibition,the detection of PDR was particularly necessary.This study aimed to determine the prevalence of PDR in Guangdong,China,and its impact on antiretroviral therapy(ART)in treatment-naive HIV patients.Methods:A retrospective cohort study was conducted.A total of 1936 HIV-1-infected treatment-naive patients in the clinic of the infectious department,Guangzhou Eighth People’s Hospital,between August 2018 and December 2019 were assayed for PDR mutations before initiating ART.Patients with PDR mutations(PDR arm)were screened and compared with those without drug-resistant mutations(non-PDR arm).The rate of HIV-1 virologic failure(VF)and CD4^(+)T-cell counts of the 2 arms were compared at the 96th week after ART to evaluate the impact of PDR on the efficacy of ART.Results:Pretreatment drug resistance was detected in 125 cases(6.46%)from the 1936 enrolled participants,most of which were resistant to non-nucleoside reverse transcriptase inhibitors(64.00%,80/125).One hundred and eight of 125 completed the follow-up of 96 weeks(PDR arm).In this cohort,52 patients whose ART regimen containing the resistant drug were grouped as con-PDR arm,and the remaining 56 patients whose ART regimen did not contain the resistant drug were grouped as non-con-PDR arm.A total of 125 patients without PDR were randomly selected as the control group(non-PDR arm),112 of whom had completed the 96-week followup.At the 96th week after ART initiation,7 patients(6.5%,7/108)in the PDR arm and 1 patient(0.9%,1/112)in the non-PDR arm developed VF,exhibiting a significant difference(χ^(2)=4.901,P=0.029).Meanwhile,3 patients(5.8%,3/52)in the con-PDR arm developed VF;the rate was also higher than that in the non-PDR arm,but without a significant difference(χ^(2)=3.549,P=0.095).The CD4^(+)T-cell count in the non-PDR arm increased more than the PDR arm(386.6 vs.319.1 cells/μL,t=2.448,P=0.015)or the con-PDRarm(386.6 vs.325.1 cells/μL,t=1.821,P=0.070)at 12weeks afterART.However,no significant differenceswere observed in the CD4^(+)T-cell count from the 24th week after ART onward.Conclusions:Pretreatment drug resistance was moderately prevalent in Guangdong,China,and could affect the antiretroviral efficacy during a 96-week observation period,indicating the need to closely monitor PDR before ART initiation.
