Low rate of pre-exposure prophylaxis and post-exposure prophylaxis uptake and high prevalence of transmitted drug resistance among newly diagnosed primary HIV infections in Shenzhen, China: a real-world retrospective study

Peng, Qiaoli1,2; Liu, Xiaoning1,2,3; Tang, Xian1,2; Zhang, Qiuyue1,2; Zhao, Jin4; Zheng, Chenli4; Zhao, Fang1,2; Zhou, Yang1,2; Zhang, Lukun1,2; Sun, Liqin1,2; Zhang, Haitao1,2; Jia, Xinyun1,2; Song, Ying1,2; Cao, Tingzhi1,2; Wang, Siyuan1,2; Rao, Man1,2; Chen, Zhiwei1,2,5; Wang, Hui1,2; He, Yun1,2

2022-11-20

10.1097/CM9.0000000000002510

CHINESE MEDICAL JOURNAL   Impact Factor & Quartile

0366-6999

2542-5641

Background:Understanding the characteristics of newly diagnosed primary human deficiency virus-1 (HIV-1) infection in the context of the post-antiretroviral therapy era and HIV drug prophylaxis is essential for achieving the new target of 95-95-95-95 by 2025. This study reported the characteristics of newly diagnosed primary HIV-1 infection in Shenzhen.Methods:This is a real-world retrospective study. Eighty-seven newly diagnosed primary HIV-1-infected patients were recruited from January 2021 to March 2022 at the Third People's Hospital of Shenzhen. Demographic, epidemiological, diagnostic, drug resistance, and medical data were described and analyzed.Results:Overall, 96.6% (84/87) of the newly identified primary HIV-1-infected patients were male, including 88.5% (77/87) men have sex with men (MSM), with a median age of 29.0 years (Q(1)-Q(3): 24.0-34.0 years); of these, 85.1% (74/87) reported high-risk sexual behaviors with casual partners. The rate of condom usage was only 28.7% (25/87). The overall rate of pre-exposure prophylaxis (PrEP) and post-exposure prophylaxis (PEP) was 8.0% (7/87, including 4 PrEP and 3 PEP cases) around the potential exposure, although 41.4% of the patients had prior awareness of such interventions. Moreover, only 19.5% (17/87) had previously used PrEP or PEP. Of those, 58.8% (10/17) of the patients obtained drugs from the internet, and only 35.3% (6/17) reported good compliance. A total of 54.0% (47/87) of subjects were diagnosed by the HIV nucleic acid test. Acute retroviral syndrome appeared in 54.0% (47/87) of patients. The prevalence of transmitted drug resistance (TDR) mutation was 33.9% (19/56), including 6 (10.7%) against nucleoside reverse transcriptase inhibitor (NRTI) plus non-nucleoside reverse transcriptase inhibitor (NNRTI), 8 (14.3%) against NNRTI, and 5 (8.9%) against protease inhibitor (PI) only.Conclusions:Owing to the low utilization rate and incorrect usage of PrEP and PEP, massive efforts are needed to promote HIV-preventive strategies in the MSM population. The extremely high prevalence of TDR mutation in this population implies the need for future pretreatment drug resistance surveillance.

Antiretroviral therapy Drug resistance Human immunodeficiency virus-1 Post-exposure prophylaxis Pre-exposure prophylaxis

SCI

English

First ; Corresponding

Shenzhen Science and Technology Program["JCYJ20210324131610027","JCYJ20210324131605015","JCYJ20190809170011461","JCYJ20210324132012035"]

General & Internal Medicine

Medicine, General & Internal

WOS:000936967300012

LIPPINCOTT WILLIAMS & WILKINS

CLINICAL MEDICINE

Web of Science

1.Southern Univ Sci & Technol, Peoples Hosp Shenzhen 3, HKU AIDS Inst, Natl Clin Res Ctr Infect Dis,Shenzhen Res Lab, Shenzhen 518112, Guangdong, Peoples R China
2.Southern Univ Sci & Technol, Affiliated Hosp 2, Shenzhen 518112, Guangdong, Peoples R China
3.Imperial Coll London, Natl Heart & Lung Inst, Fac Med, London, England
4.Shenzhen Ctr Dis Control & Prevent, Shenzhen 518073, Guangdong, Peoples R China
5.Univ Hong Kong, AIDS Inst, Li Ka Shing Fac Med, Dept Microbiol, Hong Kong 999077, Peoples R China

Peng, Qiaoli,Liu, Xiaoning,Tang, Xian,et al. Low rate of pre-exposure prophylaxis and post-exposure prophylaxis uptake and high prevalence of transmitted drug resistance among newly diagnosed primary HIV infections in Shenzhen, China: a real-world retrospective study[J]. CHINESE MEDICAL JOURNAL,2022,135(22).

Peng, Qiaoli.,Liu, Xiaoning.,Tang, Xian.,Zhang, Qiuyue.,Zhao, Jin.,...&He, Yun.(2022).Low rate of pre-exposure prophylaxis and post-exposure prophylaxis uptake and high prevalence of transmitted drug resistance among newly diagnosed primary HIV infections in Shenzhen, China: a real-world retrospective study.CHINESE MEDICAL JOURNAL,135(22).

Peng, Qiaoli,et al."Low rate of pre-exposure prophylaxis and post-exposure prophylaxis uptake and high prevalence of transmitted drug resistance among newly diagnosed primary HIV infections in Shenzhen, China: a real-world retrospective study".CHINESE MEDICAL JOURNAL 135.22(2022).