A total of 682 patients from 8 sites including Hong Kong (2 sites), Malaysia (2 sites), and Thailand (4 sites) were included in this analysis. The mean age was 38.2 years (SD, 10.1 years); 65.5% of the patients were male. The ethnicities of patients included Thai (500, 73.3%), Chinese (134, 19.6%), Malay (26, 3.8%), Indian (7, 1.0%), Indonesian (3, .4%), Filipino (1, .1%), and others (11, 1.8%). The majority (74.9%) of patients reported heterosexual contact as their primary risk exposure for HIV-1; other risk categories included homosexual contact (18.2%), intravenous drug use (2.3%), receipt of blood products (.3%), and mixed exposure (3.2%). More than one-third of patients were in CDC disease stage C. The median CD4+ cell count was 100 cells/μL (interquartile range, 34–201 cells/μL), and the median HIV-1 RNA level was 100,000 copies/mL (interquartile range, 43,581–6,040,000 copies/mL). Overall, 77.7% of patients were infected with HIV-1 subtype CRF01_AE; other subtypes included B (16.3%), C (.7%), A (.1%), other Circulating Recombinant Forms (CRFs) (2.4%), or were missing (2.9%). Co-infection with HBV was seen in 5.1% of patients, and that with HCV was seen in 7.9% of patients.
The prevalence of patients with ≥1 RAM to any drug class was 13.8%, including RAMs to nucleoside reverse transcriptase inhibitors (NRTIs; prevalence, 8.4%), nonnucleoside reverse transcriptase inhibitors (NNRTIs; prevalence, 6.5%), and protease inhibitors (PIs; prevalence, .4%). shows the distribution and frequency of each RAM that was detected. K70R was the most common RAM to NRTIs (52 patients [7.6%]); M41L, D67N, T69S, M184V, L210W, T215Y, and K219Q were observed in <1% of patients. RAMs to etravirine were detected in 44 patients (6.5%) and those to efavirenz or nevirapine in 4 patients (.6%). The most common RAMs to etravirine were V179D (22 patients [3.2%]) and V106I (13 patients [1.9%]); other RAMs were found in <1% of patients. The RAMs observed to efavirenz or nevirapine were Y181C (3 patients [.4%]), V108I (1 patient [.1%]), and G190A (1 patient [.1%]). RAMs D30N, M46I, and I54M to PIs were each observed in .1% of patients (1 patient each).
Distribution of resistance-associated mutations among 682 antiretroviral-naïve human immunodeficiency virus type 1 (HIV-1)–infected patients.
The median CD4+ cell count was significantly lower among patients with RAMs when compared with those without RAMs (66 vs 108 cells/μL, respectively; P = .009). There were no differences between patients with RAMs and those without RAMs in age, sex, site location, ethnicity, risk exposure, HIV-1 subtype, HBV co-infection, HCV co-infection, or HIV-1 RNA level.