Progress in Transmitted HIV-1 Drug Resistance
Recently, the research group led by Prof. Rongge Yang, as the only Chinese team, has made important progress in research on transmitted HIV-1 Drug Resistance with other international experts on HIV/AIDS. The research paper, Geographic and Temporal Trends in the Molecular Epidemiology and Genetic Mechanisms of Transmitted HIV-1 Drug Resistance: An Individual-patient-and sequence-level meta-analysis has been published on PLoS Med, which is an international well-known journal.
Regional and subtype-specific mutational patterns of HIV-1 transmitted drug resistance (TDR) are essential for informing first-line antiretroviral (ARV) therapy guidelines and designing diagnostic assays for use in regions where standard genotypic resistance testing is not affordable. In order to understand the molecular epidemiology of TDR and to identify the HIV-1 drug-resistance mutations responsible for TDR in different regions and virus subtypes, the research team reviewed all GenBank submissions of HIV-1 reverse transcriptase sequences with or without protease and identified 287 studies published between 2000 and 2013. These studies comprised 50,870 individuals from 111 countries.
The study found that most TDR strains in sub-Saharan Africa and South/Southeast Asia arose independently, suggesting that ARV regimens with a high genetic barrier to resistance combined with improved patient adherence may mitigate TDR increases by reducing the generation of new ARV-resistant strains. A small non-nucleoside number of reverse transcriptase inhibitor resistance mutations were responsible for most cases of high-level resistance, suggesting that inexpensive point-mutation assays to detect these mutations may be useful for pre-therapy screening in regions with high levels of TDR. In the context of a public health approach to ARV therapy, a reliable point-of-care genotypic resistance test could identify which patients should receive standard first-line therapy and which should receive a protease-inhibitor-containing regimen, which can offer the crucial strategic basis for optimizing the current clinical treatment plan of HIV/AIDS all around the world.