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. 2019 Aug 23;19(1):741.
doi: 10.1186/s12879-019-4389-1.

Trend of HIV transmitted drug resistance before and after implementation of HAART regimen restriction in the treatment of HIV-1 infected patients in southern Taiwan

Ya-Wei Weng  1 , I-Tzu Chen  1 , Hung-Chin Tsai  2   3   4   5 , Kuan-Sheng Wu  1   6 , Yu-Ting Tseng  1 , Cheng-Len Sy  1 , Jui-Kuang Chen  1 , Susan Shin-Jung Lee  1   6 , Yao-Shen Chen  1   6
Affiliations

Trend of HIV transmitted drug resistance before and after implementation of HAART regimen restriction in the treatment of HIV-1 infected patients in southern Taiwan

Ya-Wei Weng et al. BMC Infect Dis. .

Abstract

Background: The use of fixed combination antiretroviral therapy with a low genetic barrier for the treatment of patients infected with human immunodeficiency virus (HIV) may affect the local HIV transmitted drug resistance (TDR) pattern. The present study aimed to investigate changes in the prevalence of HIV TDR following the implementation of a fixed regimen of HIV treatment in Taiwan in 2012.

Methods: TDR was measured in antiretroviral treatment-naïve HIV-1-infected individuals who participated in voluntary counseling and testing between 2007 and 2015 in southern Taiwan. Antiretroviral resistance mutations were interpreted using the HIVdb program from the Stanford University HIV Drug Resistance Database.

Results: Sequences were obtained from 377 consecutive individuals between 2007 and 2015. The overall prevalence rates of TDR HIV among the study population from 2007 to 2011 and 2012-2015 were 10.6 and 7.9%, respectively. Among the detected mutations, K103 N and V179D + K103R were more frequently observed after 2012. Four HIV-infected patients with K103 N variants were detected after 2012, and 4 of the 5 patients with V179D + K103R variants were found after 2012. No significant differences were observed in the TDRs among nucleoside reverse transcriptase inhibitors (NRTIs), non-NRTIs (NNRTIs), protease inhibitors, multiple drug resistance, and any drug resistance between period 1 (2007-2011) and period 2 (2012-2015).

Conclusions: A fixed treatment regimen with zidovudine/lamivudine + efavirenz or nevirapine as first-line therapy for treatment-naïve patients infected with HIV did not significantly increase the TDR during the 4-year follow-up period. Due to the increase in NNRTI resistance associated with mutations after 2012, a longer follow-up period and larger sample size are needed in future studies.

Keywords: Drug resistance; HIV; Treatment naïve.

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Conflict of interest statement

The authors declare taht they have no competing interests.

Figures

Fig. 1
Fig. 1
Frequency of resistance to NRTIs, NNRTIs, PIs and INSTIs between 2007 and 2015(data for INSTIs were only available from 2013). NRTI, nucleoside reverse transcriptase inhibitor; NNRTI, non-nucleoside reverse transcriptase inhibitor; PI, protease inhibitor; INSTI, integrase strand transfer inhibitor
Fig. 2
Fig. 2
Comparison of transmitted drug resistance between fixed and flexible regimens for HIV management (flexible regimen, before 2012; fixed regimen, after 2012). The P-values were 0.75, 0.43, > 0.99 and 0.36 for NRTIs, NNRTIs, multi drug resistance and any drugs, respectively. NRTI, nucleoside reverse transcriptase inhibitor; NNRTI, non-nucleoside reverse transcriptase inhibitor
Fig. 3
Fig. 3
Percentage of patients with specific mutations, by drug class
See this image and copyright information in PMC

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