Emergence of HIV-1 Drug Resistance Mutations Among Children and Adolescents Undergoing Prolonged Antiretroviral Therapy in Guangxi

Xianwu Pang; Hongyan Lu; Qin He; Kailing Tang; Jie Ma; Siya Chen; Jinghua Huang; Ningye Fang; Haomin Xie; Guanghua Lan; Shujia Liang

doi:10.1016/j.jgar.2024.03.013

Emergence of HIV-1 Drug Resistance Mutations Among Children and Adolescents Undergoing Prolonged Antiretroviral Therapy in Guangxi

J Glob Antimicrob Resist. 2024 Apr 10:S2213-7165(24)00065-1. doi: 10.1016/j.jgar.2024.03.013. Online ahead of print.

Authors

Xianwu Pang¹, Hongyan Lu², Qin He¹, Kailing Tang¹, Jie Ma¹, Siya Chen², Jinghua Huang¹, Ningye Fang¹, Haomin Xie¹, Guanghua Lan³, Shujia Liang⁴

Affiliations

¹ Guangxi Key Laboratory of Major Infectious Disease Prevention Control and Biosafety Emergency Response, Guangxi Key Laboratory of AIDS Prevention Control and Translation, Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning, Guangxi, China; Guangxi Zhuang Autonomous Region Academy of Preventive Medicine, Nanning, Guangxi, China.
² Guangxi Zhuang Autonomous Region Academy of Preventive Medicine, Nanning, Guangxi, China; AIDS care clinic, Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning, Guangxi, China.
³ Guangxi Key Laboratory of Major Infectious Disease Prevention Control and Biosafety Emergency Response, Guangxi Key Laboratory of AIDS Prevention Control and Translation, Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning, Guangxi, China; Guangxi Zhuang Autonomous Region Academy of Preventive Medicine, Nanning, Guangxi, China. Electronic address: lgh605@163.com.
⁴ Guangxi Key Laboratory of Major Infectious Disease Prevention Control and Biosafety Emergency Response, Guangxi Key Laboratory of AIDS Prevention Control and Translation, Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning, Guangxi, China; Guangxi Zhuang Autonomous Region Academy of Preventive Medicine, Nanning, Guangxi, China. Electronic address: liangshujia@126.com.

PMID: 38608935
DOI: 10.1016/j.jgar.2024.03.013

Abstract

Objective: Antiretroviral therapy (ART) has been implemented in Guangxi for a long time, and no reports about HIV drug resistance mutation (DRM) among children and adolescents experiencing virological failure after ART. This study aimed to analyze HIV DRM prevalence, patterns, and influencing factors among children and adolescents experiencing virologic failure after ART in Guangxi.

Methods: We collected samples from a total of 491 HIV-infected individuals under 18 years old experiencing virological failure after ART from 14 cities in Guangxi. Sequencing and DRM analysis were performed based on pol region. Multivariate logistic regression was employed to analysis the influencing factors of DRM.

Results: Among these patients, 396 cases were successfully sequenced. Of all, 52.53% exhibited HIV DRM, including NNRTI (48.48%), NRTI (34.85%) and PI (1.01%). NRTI and NNRTI dual-class resistance was prevalent (30.3%). M184V/I and K103N mutations were the common mutations in NRTI and NNRTI respectively. Men gender (aOR=2.1, 95%CI: 1.26-3.50), CRF01_AE subtype (OR=2.50, 95%CI: 1.02-5.88), the primary regimen 3TC+AZT+NVP (OR=10.00, 95%CI: 5.00-25.00), low pre-treatment CD4+ T lymphocytes (<200 cells/mm³) (OR=1.85, 95%CI: 1.00-3.45), and high viral load (> 1000 copies/ml) (OR=4.90, 95%CI: 1.03-23.39) shown higher risk of DRM.

Conclusion: HIV DRM is pervasive among children and adolescents experiencing virologic failure in Guangxi. Timely HIV DRM monitoring is crucial to mitigate major mutation accumulation and inform effective treatment strategies.

Keywords: HIV-1; adolescents; antiretroviral therapy; children; drug resistance.