title: HIV-1 drug-resistant mutations and related risk factors among HIV-1-positive individuals experiencing treatment failure in Hebei Province, China.
abstract: BACKGROUND
  To understand HIV-1 drug resistance in 11 prefectures of Hebei Province, China, we implemented a cross-sectional HIV-1 molecular epidemiological survey.
  
  
  METHODS
  Blood samples were collected from 122 newly diagnosed drug-naïve HIV-1-positive individuals and 229 antiretroviral therapy (ART)-failure individuals from 11 prefectures in Hebei Province, China. Patient demographic data were obtained via face-to-face interviews using a standardized questionnaire when blood samples were collected. Genotyping of HIV-1 drug resistance (DR) was implemented using an in-house assay.
  
  
  RESULTS
  In this study, the overall prevalence of HIV-1 DR was 35.5%. The prevalence of HIV-1 DR in participants experiencing treatment failure and ART-naïve participants was 51.9 and 5.9%, respectively. Mutations in protease inhibitors, nucleoside reverse transcriptase inhibitors (NRTIs), and non-NRTI (NNRTIs), as well as dual and multiple mutations were extensively seen in participants experiencing treatment failure. The proportions of NNRTI mutations (χ2= 9.689, p = 0.002) and dual mutations in NRTIs and NNRTIs (χ2= 39.958, p < 0.001) in participants experiencing treatment failure were significantly higher than those in ART-naïve participants. The distributions of M184V/I and M41L mutations differed significantly among three main HIV-1 genotypes identified. Viral load, symptoms in the past 3 months, CD4 counts, transmission route, and the duration of ART were found to be associated with HIV-1 DR.
  
  
  CONCLUSIONS
  Our results suggest that new prevention and control strategies should be formulated according to the epidemic characteristics of HIV-1-resistant strains in Hebei Province, where antiretroviral drugs are widely used.
authors.affiliation: Hebei Provincial Center for Disease Control and Prevention, 97 Huaian East Road, Yuhua District, Shijiazhuang, 050021, China.
authors.forename: Xinli
authors.initials: X
authors.lastname: Lu
authors.affiliation: Hebei Provincial Center for Disease Control and Prevention, 97 Huaian East Road, Yuhua District, Shijiazhuang, 050021, China.
authors.forename: Hongru
authors.initials: H
authors.lastname: Zhao
authors.affiliation: Hebei Provincial Center for Disease Control and Prevention, 97 Huaian East Road, Yuhua District, Shijiazhuang, 050021, China.
authors.forename: Yuqi
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Hebei Provincial Center for Disease Control and Prevention, 97 Huaian East Road, Yuhua District, Shijiazhuang, 050021, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Wang
authors.affiliation: Hebei Provincial Center for Disease Control and Prevention, 97 Huaian East Road, Yuhua District, Shijiazhuang, 050021, China.
authors.forename: Cuiying
authors.initials: C
authors.lastname: Zhao
authors.affiliation: Hebei Provincial Center for Disease Control and Prevention, 97 Huaian East Road, Yuhua District, Shijiazhuang, 050021, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Li
authors.affiliation: Hebei Provincial Center for Disease Control and Prevention, 97 Huaian East Road, Yuhua District, Shijiazhuang, 050021, China.
authors.forename: Lin
authors.initials: L
authors.lastname: Ma
authors.affiliation: Hebei Provincial Center for Disease Control and Prevention, 97 Huaian East Road, Yuhua District, Shijiazhuang, 050021, China. hbcdc888@163.com.
authors.forename: Ze
authors.initials: Z
authors.lastname: Cui
authors.affiliation: Hebei Provincial Center for Disease Control and Prevention, 97 Huaian East Road, Yuhua District, Shijiazhuang, 050021, China. hebeicdc2013@sina.com.
authors.forename: Suliang
authors.initials: S
authors.lastname: Chen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D019380:Anti-HIV Agents / Q000627:therapeutic use; D002648:Child; D002681:China / Q000453:epidemiology; D003430:Cross-Sectional Studies; D024882:Drug Resistance, Viral / Q000235:genetics; D005260:Female; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology / Q000821:virology*; D015497:HIV-1 / Q000187:drug effects / Q000235:genetics* / Q000302:isolation & purification; D006801:Humans; D008297:Male; D008875:Middle Aged; D009154:Mutation; D015995:Prevalence; D012307:Risk Factors; D017211:Treatment Failure; D019562:Viral Load; D055815:Young Adult
chemical_list: D019380:Anti-HIV Agents
keywords: China; Drug resistance; HIV-1; Mutation; Phylogeny