Analysis on pre-antiretroviral treatment drug resistance in people infected with HIV-1CRF08_BC in China, 2004−2022

Objective To investigate the pre-antiretroviral treatment resistance to protease inhibitors (PIs), nucleoside reverse transcriptase inhibitors (NRTIs), and non-nucleoside reverse transcriptase inhibitors (NNRTIs) in people infected with HIV-1 CRF08_BC in China.

Methods From national HIV drug resistance survey database and HIV database of China and Los Alamos HIV gene database, HIV-1 CRF08_BC sequences were selected in pre-antiretroviral treatment samples collected between 2004 and 2022. Drug resistance was analyzed by using Stanford HIVdb Program. Molecular transmission networks were constructed by using software HIV-TRACE.

Results A total of 4 539 HIV-1 CRF08_BC sequences were included, and the overall drug resistance rate was 15.27% (693/4539). The resistance rates to PIs, NRTIs and NNRTIs were 1.70% (77/4 539), 1.85% (84/4 539), and 12.91% (586/4 539), respectively. In which the resistance rate to rilpivirine was highest (11.28%, 512/4539). The rate of multi-drug resistance was 0.1% (44/4539).

Conclusion In recent years, the drug resistance rate in HIV-1 CRF08_BC-infected patients increased in China, which could be explained by increased resistance to NNRTIs, in which the resistance rate to rilpivirine was highest. The transmission of drug-resistant strains exists in China, indicating that pre-antiretroviral treatment drug resistance on antiretroviral therapy needs to be further monitored and analyzed.