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Updated: May 30, 2025
Rapid Screening of HIV Reverse Transcriptase and Integrase Inhibitors
Published on: April 9, 2014
Pretreatment HIV Drug Resistance to Integrase Strand Transfer Inhibitors Among Newly Diagnosed HIV Individuals -
Hongping Hu1, Jingjing Hao1, Dong Wang1
1State Key Laboratory of Infectious Disease Prevention and Control, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China.
Introduction:
The widespread adoption of integrase strand transfer inhibitors (INSTIs) has led to the emergence of INSTI-associated drug-resistance mutations. This cross-sectional study conducted a comprehensive national survey to investigate the prevalence of pretreatment drug resistance (PDR) to INSTIs among newly diagnosed human immunodeficiency virus (HIV) individuals in China.
Methods:
The study enrolled 10,654 individuals from 31 provincial-level administrative divisions between 2018 and 2023. All participants underwent integrase region genotypic resistance testing. PDR to INSTIs was analyzed using the Stanford HIV drug resistance database, and molecular transmission networks were constructed using HIV-TRACE.
Results:
The overall PDR prevalence of INSTIs was 0.95%. The predominant major and accessory mutations identified were E138K/A (n=19) and G163R/K (n=29), respectively. Multivariable logistic regression analysis revealed that age ≥50 years [adjusted odds ratio (aOR)=1.87, 95% confidence interval (CI): 1.03, 3.42] and HIV subtype B (aOR=3.87, 95% CI: 1.97, 7.58) were significant risk factors for PDR. Molecular network analysis showed that 1,257 (26.0%) CRF07_BC sequences formed 432 transmission clusters, while 811 (27.6%) CRF01_AE sequences were associated with 335 clusters. The identified drug-resistance mutations included E138K/A, R263K, Y143H, G163R/K, E157Q, and T97A.
Conclusions:
The current prevalence of PDR to INSTIs in China remains low. However, given the increasingly widespread use of INSTIs, continuous surveillance of drug resistance emergence and transmission patterns is essential.
