Drug resistance and HCV coinfection in former blood donors infected with HIV type 1 in China.
Unhygienic blood collection caused an outbreak of HIV-1 and HCV infections among blood donors in rural areas in Henan province, China. Partial HIV-1 pol and HCV NS5b gene sequences were obtained from 97 persons infected with HIV-1 to determine the efficacy of treatment, the prevalence of drug-resistant mutations, and the impact of HCV infection on disease progression of infection with HIV-1. After antiretroviral therapy, 60 out of 97 HIV-1-infected blood donors had their HIV-1 RNA levels reduced to an undetectable level. Drug-resistant mutations to reverse transcriptase inhibitors were detected in one-third of treatment failure patients, with K103N as the most frequent mutation. Drug-resistant mutations were not detected in the other two-thirds of treatment-failure patients, suggesting a poor adherence to the treatment. The majority of HIV-1-infected patients (91.8%) were also infected with HCV. Sequence analysis showed that they were infected with HCV subtype 1b (47.5%) or 2a (52.5%). HCV viral loads were significantly higher in patients infected with subtype 2a than in patients infected with HCV subtype 1b, although no differences in HIV-1 viral loads and CD4(+)T cell counts was observed between the two subtypes. These results suggest that improved adherence and treatment regimens will be critical to effectively treat HIV-1 and HCV-coinfected patients in resource-limited areas.
Department of Microbiology, Peking University Health Science Center, Beijing, China.
Jia
J
Liu
Xiangmei
X
Chen
Qing
Q
Xie
Weidong
W
Zhang
Lai
L
Wei
Tao
T
Shen
Qiang
Q
Xu
Hui
H
Zhuang
Feng
F
Gao
Fengmin
F
Lu
D000328:Adult; D023241:Antiretroviral Therapy, Highly Active; D001782:Blood Donors; D018791:CD4 Lymphocyte Count; D002681:China; D018450:Disease Progression; D024882:Drug Resistance, Viral / Q000187:drug effects / Q000235:genetics*; D005260:Female; D015751:Genes, pol; D015658:HIV Infections / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology / Q000821:virology; D015497:HIV-1 / Q000187:drug effects / Q000235:genetics*; D016174:Hepacivirus / Q000187:drug effects / Q000235:genetics*; D006526:Hepatitis C / Q000150:complications / Q000188:drug therapy* / Q000453:epidemiology / Q000821:virology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009154:Mutation; D010349:Patient Compliance; D010802:Phylogeny; D015995:Prevalence; D012194:RNA-Directed DNA Polymerase / Q000378:metabolism*; D018894:Reverse Transcriptase Inhibitors / Q000494:pharmacology / Q000627:therapeutic use*; D016896:Treatment Outcome; D019562:Viral Load
D018894:Reverse Transcriptase Inhibitors; D012194:RNA-Directed DNA Polymerase