RESUMO
To optimise patients' outcomes and gain insight into transmitted drug resistance (TDR) among human immunodeficiency virus (HIV)-1 treatment-naive patients in Beijing, the prevalence of TDR was assessed. Demographic and clinical data of 1241 treatment-naive patients diagnosed between April 2014 and February 2015 were collected. TDR was defined using the Stanford University HIV drug resistance mutations database. The risk factors were evaluated by multi-logistic regression analysis. Among 932 successfully amplified cases, most were male (96.78%) and infected through men having sex with men (91.74%). Genotype were CRF01_AE (56.44%), B (20.60%), CRF07_BC (19.96%), C (1.61%) and other genotypes (1.39%). The overall prevalence of TDR was 6.12%. Most frequent mutations occurred in non-nucleoside reverse transcriptase inhibitors (NNRTIs) (3.11%), followed by protease inhibitors (PIs) (2.25%) and nucleoside reverse transcriptase inhibitors (NRTIs) (1.32%). Furthermore, HIV-1 genotype was associated with high risk of resistance, in which genotype C and other genotype may have higher risk for resistance. The prevalence among treatment-naive patients in Beijing was low. Resistance to NNRTIs was higher than with PIs or NRTIs. Continuous monitoring of regional levels of HIV-1 TDRs would contribute to improve treatment outcomes and prevent failures.
Assuntos
Síndrome da Imunodeficiência Adquirida/epidemiologia , Fármacos Anti-HIV/farmacologia , Farmacorresistência Viral/genética , HIV-1/efeitos dos fármacos , Inibidores de Proteases/farmacologia , Inibidores da Transcriptase Reversa/farmacologia , Síndrome da Imunodeficiência Adquirida/transmissão , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Pequim/epidemiologia , HIV-1/genética , HIV-1/fisiologia , Homossexualidade Masculina , Humanos , Masculino , Pessoa de Meia-Idade , Mutação , Prevalência , Adulto JovemRESUMO
Objective: To understand the HIV prevalence among men who have sex with men (MSM) and discuss the feasibility of respondent driven sampling (RDS) as a tool to conduct long term HIV surveillance in MSM in Beijing. Methods: From 2005 to 2012 RDS was used to recruit MSM for face-to-face interview with structured questionnaire to collect their demographic characteristics and HIV risk-related behavior. Blood samples were collected from them for HIV test. Results: A total of 427, 540, 607, 614, 616, 602, 579 and 600 MSM were surveyed, respectively, from 2005 to 2012. The HIV infection prevalence increased from 4.2%(95%CI: 1.9-7.0) in 2005 to 10.1% (95%CI: 7.2-13.2) in 2012 (P=0.02). Meanwhile, HIV prevalence substantially increased among MSM aged >25 years, in floating population and with lower education level (≤high school), from 6.4%(95%CI: 2.2-9.5), 3.3%(95%CI: 1.8-5.4) and 5.5% (95%CI: 2.2-8.9) in 2005 to 7.6% (95%CI: 5.4-10.3, P=0.04), 10.7% (95% CI: 7.8-14.6, P=0.04) and 10.4% (95% CI:7.2-14.3, P=0.04) in 2012, respectively. Moreover, the HIV infection prevalence in MSM aged ≤25 years old and with higher education level (>high school) increased from 1.7%(95%CI: 0.4-3.1) in 2009 and 1.1%(95%CI: 0.2-1.7) in 2007 to 13.7%(95%CI: 7.2-20.4) and 9.1%(95%CI: 4.7-13.8) in 2012, respectively, the differences were not significant. Furthermore, the HIV infection prevalence in MSM who had 2-9 male sex partners in the last six months increased from 4.0% (95% CI: 1.0-8.0) in 2005 to 12.6% (95% CI: 8.7-16.7) in 2012 (P=0.02). Conclusions: Studies have shown that RDS is an effective and feasible sampling method for long term HIV surveillance in MSM. The HIV infection prevalence in MSM in Beijing increased from 2005 to 2012, especially among those with older age, in floating population and with lower educational level. More attention should be paid to MSM with younger age and with higher educational level.
Assuntos
Infecções por HIV , Homossexualidade Masculina , Adulto , Pequim , Humanos , Masculino , Programas de Rastreamento , Prevalência , Fatores de Risco , Comportamento Sexual , Parceiros Sexuais , Manejo de Espécimes , Inquéritos e QuestionáriosRESUMO
We amplified gag sequences from 66 individuals infected with HIV-1 CRF07_BC during 2003-2005 in the Xinjiang region of China. A novel deletion of 7aa (including a KELY motif) in the central region of the CRF07_BC gag p6 domain was detected, which has not been reported in other HIV-1 subtypes. Further deletions of up to 13aa (including KQE and KELY motifs) was also found in this domain, representing the biggest natural deletion up to now. Moreover, the CD4+ count and viral load level indicated that 1-13aa deletions in CRF07_BC gag p6 do not have a significant effect on viral replication and fitness.