No Difference in Prevalence of Transmitted Drug Resistance between Injection Drug Users and Non-Injection Drug Users: A Cross-Sectional Study among Antiretroviral Treatment-Naïve HIV Patients

Intervirology. 2018;61(6):281-291. doi: 10.1159/000499367. Epub 2019 Apr 24.

Abstract

Objectives: The epidemiological evidence is inconsistent about whether HIV-positive injection drug users (IDUs) are at higher risk of developing antiretroviral resistance than any other HIV-positive populations. This study aims to investigate and compare transmitted drug resistance (TDR) between IDUs and non-IDUs in Lingshan County, an HIV-hit region in Guangxi, China, where IDU and heterosexual transmission were the two dominant transmission routes and roughly equally contributed to the local HIV transmission.

Methods: A cross-sectional study was conducted among newly diagnosed and antiretroviral-treatment (ART)-naïve HIV-1 patients from Lingshan County. The pol gene of HIV-1 from the individuals was sequenced followed by genotyping and TDR analysis.

Results: Two dominant transmission routes, heterosexual contact and IDU, accounted for 49.2 and 45.9% of 183 HIV-1 infection cases, respectively. Three genotypes, including CRF08_BC (70.6%), CRF01_AE (24.4%), and CRF07_BC (5.0%), and three unique recombinant forms (1.6%), were identified. There was a significant difference in genotype distribution among the different transmission routes (F = 21.814, p < 0.001). The overall TDR prevalence was 5.5%. There were no significant differences in TDR prevalence among the different transmission routes (F = 1.420, p = 0.439).

Conclusions: Injection drug use has little impact on TDR prevalence compared with other routes of transmission.

Keywords: HIV-1; Injection drug use; Transmitted drug resistance.

MeSH terms

  • Adult
  • Aged
  • Antiretroviral Therapy, Highly Active
  • CD4 Lymphocyte Count
  • China / epidemiology
  • Cross-Sectional Studies
  • Drug Resistance, Viral*
  • Drug Users*
  • Female
  • Genotype
  • HIV Infections / drug therapy
  • HIV Infections / epidemiology*
  • HIV Infections / transmission
  • HIV Infections / virology*
  • HIV-1 / drug effects*
  • HIV-1 / genetics
  • Humans
  • Male
  • Middle Aged
  • Mutation
  • Phylogeny
  • Prevalence
  • Recombination, Genetic
  • Viral Load
  • Young Adult