Prevalence and trends in human immunodeficiency virus-1 subtypes and
drug resistance in South Korea: Analysis of 5 years’ data (2017‒2022)
Abstract
The clinical guidelines for acquired immunodeficiency syndrome (AIDS) in
HIV-infected Koreans recommend routine HIV drug resistance testing for
patients undergoing their first highly active antiretroviral therapy or
considering a change in medication after 2018. Herein, the trends in
HIV-1 subtypes and drug resistance were assessed from 2017 to 2022 by
retrospectively analyzing 2,107 HIV-1-infected patients’ data. The
Stanford HIV Drug Resistance Database was used to analyze each patient’s
HIV-1 polymerase ( pol) gene sequences. Subtype B infections were
predominant in the study population (75.7%). Meanwhile, CRF01_AE was
the most prevalent non-B subtype and increased from 58.4% to 73.7%
during the study period. Overall, all types of drug resistance mutations
(DRM) were detected in 34.7% of the HIV-1 pol sequences. The prevalence
of DRMs and high-level resistance mutations decreased from 39.4% to
31.6% and 16.7% to 7.7%, respectively. The prevalence of DRM was
higher in patients treated with antiretroviral therapy (ART). These
findings indicate that the prevalence of non-B subtype HIV infection has
increased rapidly in South Korea, and the overall prevalence of DRMs
decreased between 2017 and 2022. Additionally, since DRM is high in
ART-treated patients, routine standard genotypic resistance testing
surveillance is important before and after the treatment.