Transmitted drug resistance profiles among people living with HIV-1 in Henan province, China, 2024

Following with the widespread adoption of antiretroviral treatment (ART) for human immunodeficiency virus type 1 (HIV-1), the prevalence of transmitted drug resistance (TDR) among newly diagnosed people living HIV-1 (PLWH) has shown an upward trend. Thus, a close monitoring of TDR can provide valuable data for local management of PLWH.

Plasma samples were collected from newly diagnosed PLWH seeking treatments in the Sixth People's Hospital of Zhengzhou from Jan 2024 to December 2024. The partial pol and the complete integrase gene coding sequences were separately amplified, sequenced, and analysed.

Of a total of 1249 patients, we obtained partial pol sequences from 1227 patients and integrase sequences from 1224 patients. Subtyping analysis showed predominance of CRF07_BC (41.73%, 512/1227), followed by CRF01_AE (27.06%, 332/1227), B (21.35%, 262/1227), CRF55_01B (4.81%, 59/1227), and CRF08_BC (1.96%, 24/1227). Transmitted drug resistance mutations were detected in 137 patients, giving a TDR prevalence of 11.25% (137/1227). The most frequently detected mutations leading to low-level or above drug resistance against nucleoside reverse transcriptase inhibitors, non-nucleoside reverse transcriptase inhibitors, protease inhibitors, and integrase transfer inhibitors were M184I/V, K103N/S, M46I/L/V, and E138A, respectively. The prevalence of TDR remained at a modest level and showed no significant difference when compared with previous years.

Genotypic drug resistance testing is recommended for newly diagnosed PLWH before the initiation of ART to provide effective treatment regimens.