Different Frequencies of Drug Resistance Mutations among HIV-1 Subtypes Circulating in China: A Comprehensive Study

Abstract

The rapid spreading of HIV drug resistance is threatening the overall success of free HAART in China. Much work has been done on drug-resistant mutations, however, most of which were based on subtype B. Due to different genetic background, subtypes difference would have an effect on the development of drug-resistant mutations, which has already been proved by more and more studies. In China, the main epidemic subtypes are CRF07_BC, CRF08_BC, Thai B and CRF01_AE. The depiction of drug resistance mutations in those subtypes will be helpful for the selection of regimens for Chinese. In this study, the distributions difference of amino acids at sites related to HIV drug resistance were compared among subtype B, CRF01_AE, CRF07_BC and CRF08_BC strains prevalent in China. The amino acid composition of sequences belonging to different subtypes, which were obtained from untreated and treated individuals separately, were also compared. The amino acids proportions of 19 sites in RT among subtype B, CRF01_AE and CRF08_BC have significant difference in drug resistance groups (chi-square test, p<0.05). Genetic barriers analysis revealed that sites 69, 138, 181, 215 and 238 were significantly different among subtypes (Kruskal Wallis test, p<0.05). All subtypes shared three highest prevalent drug resistance sites 103, 181 and 184 in common. Many drug resistant sites in protease show surprising high proportions in almost all subtypes in drug-naïve patients. This is the first comprehensive study in China on different development of drug resistance among different subtypes. The detailed data will lay a foundation for HIV treatment regimens design and improve HIV therapy in China.

Prevalence of transmitted drug resistance among HIV-1 treatment-naive patients in Beijing

“…These findings suggested that genotype C was the dominant strain which was resistant to ART drugs. These results, showing more TDR in subtype C and no PI or NRTI TDR in subtype B, differ from previous studies in China [6, 7] and worldwide [8–11]. However, in particular, there are reasons why our results for subtype C may be different from other studies.…”

High prevalence of HIV-1 transmitted drug resistance among therapy-naïve Burmese entering travelers at Dehong ports in Yunnan, China

“…Even considering the previous report of occurrence in Hebei and Beijing, the mutation rate of V179D/T up to 6.92% is still an astonishing level [ 30 , 31 ]. Despite of the previous report stating the possible relationship between TDRMs and HIV-1 subtype [ 32 ], there is little evidence shown in this study supporting this statement, possibly due to the relatively smaller sampled group in the investigation. However, DRMs analysis was not carried out on the mutations of integrase inhibitors in this study, which were also significant class of resistant mutations.…”

HIV drug resistance in HIV positive individuals under antiretroviral treatment in Shandong Province, China

“…A similar study we conducted in 2009 showed that ART adherence among AIDS patients in Shandong was as high as 94.75% [ 42 ], which was consistent with that among AIDS patients in central regions of China (94.75%, calculated from 1 week of ART) [ 35 ]. Sui H and Cabello M et al have also demonstrated that HIV subtype was highly associated with the development and spread of drug resistance [ 43 – 48 ].…”