Drug resistance mutations and their influencing factors in the patients infected with HIV-1 through different routes after antiretroviral therapy

Objective To analyze HIV-1 drug resistance mutations and relative factors in the patients infected with HIV-1 through different routes after having received highly active anti-retroviral therapy (HAART) in Hebei province. Methods Plasma samples were collected from patients who were infected with HIV through different routes. Detection of HIV-1 RNA pol region was carried out by detection of genotype, and HIV drug resistance mutations were analyzed. Results Among 266 patients, 157 developed mutation. The rate of the drug-resistance was 59.0%. Among 266 patients, drug-resistance rates were ranked from high to low as follows: NVP 65.8% (175/266), 3TC 41.7% (111/266), FTC 41.7% (111/266), EFV 30.1% (80/266), DDI 5.6% (15/266), D4T 4.1% (11/266), AZT 3.0% (8/266) and ABC 3.0% (8/266). The drug-resistance rate of blood infection patients was much higher than that of sexual and mother-to-child transmission ones, but χ2-test indicated that the differences in main mutation sites (Y181C, K103N, V108I, K101E in NNRTIS coding region, M184V/I, M41L, T215F, T215Y in NRTIs coding region and A71V/T, L10I, M46L, Q58E in PIs coding region) were not statistically significant (P>0.05) among the patients infected through three routes. The results of OR value and the 95% confidence interval (CI) indicated that age, infection routes, CD4+ cell count and initial therapeutic plan had a significant relevance to HIV-1 drug resistance mutation (P