Comparison of HIV-1 RNA and HIV-1 DNA Genotypic Drug Resistance Testing in Women of Childbearing Age Infected with HIV-1 in Liangshan Prefecture

This study focuses on HIV-1-infected women of childbearing age in Liangshan Prefecture and analyses their HIV-1 RNA and HIV-1 DNA genotypic drug resistance to provide a theoretical basis and technical support for monitoring the spread of resistant strains and formulating and optimizing antiretroviral therapy regimens. The study subjects were HIV-1-infected women of childbearing age who were followed up in the county of Liangshan Prefecture from January to September 2023. Peripheral venous blood samples were collected from each subject. The samples were centrifuged to separate the plasma and blood cells for HIV-1 RNA quantitative testing and HIV-1 genotypic drug resistance testing. A total of 47 participants were included in this study. When HIV-1 RNA were <50 copies/mL and between 50 and 1,000 copies/mL, the success rate of HIV-1 DNA pol gene amplification was significantly higher than that of HIV-1 RNA pol gene amplification. Among the 47 subjects, 17 (17/47, 36.17%) indicated successfully amplified HIV-1 RNA and HIV-1 DNA genotypic drug resistance in each region simultaneously, and 9 (9/17, 52.94%) developed any degree of resistance. Among these nine cases, five had consistent resistance, while four indicated inconsistent resistance. Among the five cases with identical drug resistance, there were three cases with inconsistent drug resistance mutations (DRMs). Among the four cases with inconsistent drug resistance results, one had DRMs at the HIV-1 DNA level but no DRMs at the HIV-1 RNA level, while the other three had more DRMs at the HIV-1 RNA level than at the HIV-1 DNA level. The combination of HIV-1 RNA and HIV-1 DNA genotypic drug resistance testing can improve the drawbacks of current single HIV-1 RNA genotypic drug resistance testing, especially when HIV-1 RNA is <= 1,000 copies/mL, and significantly improve the efficiency of HIV-1 genotypic drug resistance testing.