Analysis of human immunodeficiency virus genotypic drug resistance among human immunodeficiency virus infection and acquired immune deficiency syndrome individuals with virological failure after free antiretroviral therapy in Yunnan Province in 2012

Objective To investigate the prevalence and characteristics of human immunodeficiency virus (HIV)-1 drug-resistance among the HIV infection and acquired immune deficiency syndrome (HIV/AIDS) individuals with virological failure after national antiretroviral therapy in Yunnan Province in 2012. Methods Clinical and laboratory data of HIV/AIDS cases receiving national free highly active antiretroviral therapy (HAART) in 2012 were collected. HIV-1 genotypic drug resistance testing was performed in patients with the plasma viral loads over 1 000 copy/mL after antiretroviral therapy beyond 6 months. Prevalence and the characteristics of HIV-1 drug resistance were analyzed. Results A total of 1 315 cases suffered from virological failure among 31 731 cases who received HAART in 2012. The rates of drug-resistance gene mutation were 2.4% (775/31 731) in patients receiving HAART and 58.9%(775/1 315) in patients with virological failure. The sites of gene mutation were M184V/I (29.1%), K103N/S (23.7%), G190A/S/E (13.5%), Y181C/I/V (11.8%) and V179D/E/F (9.6%). The percentages of high resistance to nevirapine, efavirenz, lamivudine, zidovudine, stavudine and tenofovir were 46.5%(612/1 315), 32.6%(429/1 315), 29.3%(385/1 315), 5.2%(68/1 315), 5.0%(66/1 315) and 0.9%(12/1 315), respectively. The percentage of high resistance to lopinavir/ritonavir was 0.2%(2/1 315). Conclusions At present, the HIV-1 drug resistance is the main cause for virological failure. It is important to reduce the incidence of drug resistance and the spread of drug resistant strains during HIV/AIDS control. Key words: HIV infections; Acquired immunodeficiency syndrome; Antiretroviral therapy, highly active; Drug resistance, viral