HIV-1 Genetic Diversity and High Prevalence of Pretreatment Drug Resistance in Tianjin, China

Zeng, Rui; Ren, Doudou; Gong, Xiaowen; Wei, Min; Yu, Aimin; Zhang, Defa; Mi, Yu; Ma, Ping

doi:10.1089/aid.2020.0056

Cited by 18 publications

(16 citation statements)

References 17 publications

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“…For quality control, all the sequencing was carried out with phylogenetic analysis to determine cross-contaminations. The details of the whole protocol have already been published [13].…”

Section: Rna Extraction Pcr and Sanger Sequencingmentioning

confidence: 99%

Pre‐treatment and acquired antiretroviral drug resistance among people living with HIV in Tianjin, China

Xia

Zeng

et al. 2022

HIV Medicine

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ObjectivesThis study investigated the prevalence and patterns of pre‐treatment and acquired HIV drug resistance mutations among people living with HIV (PLWH) on antiretroviral therapy (ART) for 12 (±3) months in Tianjin, China.MethodsFrom Jan 2018 to Dec 2020, PLWH with HIV‐1 RNA greater than 1000 copies/mL visiting the ART clinic in the Tianjin Second People's Hospital were enrolled. Viral RNA isolated from blood samples were taken for genotypic resistance testing using an in‐house method. Major drug resistance mutations were analyzed for reverse transcriptase and protease Sanger sequences using the Stanford University HIV Drug Resistance Database. Multivariable Poisson regressions were used to evaluate the factors associated with drug resistance mutations.ResultsHIV drug resistance testing was successfully performed on 584 ART‐naive and 71 ART‐experienced participants. Pre‐treatment drug resistance mutation prevalence was 13.5% (79/584) to any antiretroviral drug, 12.5% (73/584) to non‐nucleoside reverse transcriptase inhibitors (NNRTIs), 1.5% (9/584) to nucleoside reverse‐transcriptase inhibitors (NRTIs), and 0.3% (2/584) to protease inhibitors (PIs). Acquired drug resistance to any antiretroviral drug among PLWH on ART with viral load >1000 copies/mL was 88.7% (63/71). The prevalence of mutation for NNRTIs, NRTIs, and PIs were 93.7% (59/63), 82.5% (52/63), and 3.2% (2/63), respectively.ConclusionsPre‐treatment and acquired drug resistance mutations were highly prevalent among PLWH in Tianjin; therefore, routine baseline genotypic resistance testing and adequate intervals of viral load surveillance are urgently needed for the long‐term treatment success. Our findings provide important evidence for first‐ and second‐line regimen drugs for PLWH, especially in China.

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“…For quality control, all the sequencing was carried out with phylogenetic analysis to determine cross-contaminations. The details of the whole protocol have already been published [13].…”

Section: Rna Extraction Pcr and Sanger Sequencingmentioning

confidence: 99%

Pre‐treatment and acquired antiretroviral drug resistance among people living with HIV in Tianjin, China

Xia

Zeng

et al. 2022

HIV Medicine

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“…Subsequently, it formulated the monitoring of drug resistant people who initiated antiretroviral therapy [ 3 ], which was recommended to monitor HIV resistance levels and factors associated with HIV drug resistance. National surveillance data showed that the prevalence of PDR was still at a low level in China [ 6 – 8 ], but the latest studies showed that PDR has reached a medium level in many parts of the country, such as Shanghai (17.4%, 55/317) [ 9 ], Tianjin (11.5%, 35/305) [ 10 ], Guangxi (7.21%, 83/1151) [ 11 ], and Beijing (6.12%, 57/932) [ 12 ]. According to the consolidated guidelines on the use of antiretroviral drugs, the proportion of NNRTIs resistance is much higher than that of NRTIs and PIs in countries with NNRTIs-based first-line treatment, and if the percent of HIV-positive individuals harboring NNRTI resistance reaches above 10%, first-line treatments would need to be modified in these settings [ 13 ].…”

Section: Introductionmentioning

confidence: 99%

Survey of pretreatment HIV drug resistance and the genetic transmission networks among HIV-positive individuals in southwestern China, 2014–2020

Xu¹,

Luo

Song³

et al. 2021

BMC Infect Dis

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Background Pretreatment drug resistance (PDR) can limit the effectiveness of HIV antiretroviral therapy (ART). The aim of this study was to assess the prevalence of PDR among HIV-positive individuals that initiated antiretroviral therapy in 2014–2020 in southwestern China. Methods Consecutive cross-sectional surveys were conducted in Qinzhou, Guangxi. We obtained blood samples from individuals who were newly diagnosed with HIV in 2014–2020. PDR and genetic networks analyses were performed by HIV-1 pol sequences using the Stanford HIV-database algorithm and HIV-TRACE, respectively. Univariate and multivariate logistic regression models were used to explore the potential factors associated with PDR. Results In total, 3236 eligible HIV-positive individuals were included. The overall prevalence of PDR was 6.0% (194/3236). The PDR frequency to NNRTI (3.3%) was much higher than that of NRTI (1.7%, p < 0.001) and PI (1.2%, p < 0.001). A multivariate logistic regression analysis revealed that PDR was significantly higher among individuals aged 18–29 (adjusted odds ratio (aOR): 1.79, 95% CI 1.28–2.50) or 30–49 (aOR: 2.82, 95% CI 1.73–4.82), and harboring CRF08_BC (aOR: 3.23, 95% CI 1.58–6.59). A total of 1429 (43.8%) sequences were linked forming transmission clusters ranging in size from 2 to 119 individuals. Twenty-two individuals in 10 clusters had the same drug resistant mutations (DRMs), mostly to NNRTIs (50%, 5/10). Conclusions The overall prevalence of PDR was medium, numerous cases of the same DRMs among genetically linked individuals in networks further illustrated the importance of surveillance studies for mitigating PDR.

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“…The prevalence of PDR in Baoding from 2019–2020 was moderate (5–15%) according to the WHO definition. This prevalence of PDR was higher than that in Hebei (6.1%) [ 21 ], Beijing (4.1%) [ 22 ], China overall (6.8%) [ 10 ] and in other areas [ 12 , 23 ], Tianjin (11.5%), Zimbabwe (6.3%), South/Southeast Asia (2.9%), upper-income Asian countries (5.6%), and Latin America/Caribbean (7.6%), but lower than that in Cameroon (9.8%), Europe (9.4%), and North-America (11.5%). Moreover, 6.1% of subjects carried NNRTI resistance-related mutations such as K101, E138, V106 and V179.…”

Section: Discussionmentioning

confidence: 87%

“…However, following global trends, the prevalence of HIV-1 strains with PDR increased from 3.7% in 2012 to 6.8% in 2017 [ 10 ]. The prevalence of PDR has reached higher levels in some areas: 17.4% in Shanghai [ 11 ], 11.5% in Tianjin [ 12 ], 12.2% in Liangshan, Sichuan Province [ 10 ], 9.3% in Dehong, Yunnan Province, and 8.9% in Lincang, Yunnan Province [ 10 ]. These data suggest that region-specific investigations of HIV-1 PDR are required.…”

Section: Introductionmentioning

confidence: 99%

Molecular transmission networks and pre-treatment drug resistance among individuals with acute HIV-1 infection in Baoding, China

et al. 2021

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Background Human immunodeficiency virus type 1 (HIV-1) genetic diversity and pre-treatment drug resistance (PDR) are major barriers to successful antiretroviral therapy (ART). In China, sexual intercourse is the most frequent route of HIV-1 transmission. However, few studies have analyzed PDR and transmission networks in detail among individuals in China with acute HIV-1 infection and their sexual contacts. Methods A cross-sectional study was conducted in Baoding City, Hebei Province, China from 2019–2020. CD4 T cell counts and viral loads were assessed and a HIV-1 genotypic PDR assay was developed in-house. Transmission networks were visualized using Cytoscape with a threshold genetic distance of 0.015 among HIV-1 subtypes. Results From 139 newly diagnosed and drug-naïve individuals with HIV-1, 132 pol gene sequences were obtained and revealed eight HIV-1 subtypes. Circulating recombinant form (CRF)01_AE was the most frequent subtype (53.0%, 70/132) followed by CRF07_BC (26.5%, 35/132), B (13.6%, 18/132), unique recombinant forms (2.3%, 3/132), CRF55_01B (1.5%, 2/132), CRF103_01B (1.5%, 2/132), CRF65_cpx (0.8%, 1/132), and C (0.8%, 1/132). A total of 47 pol gene sequences were used to generate 10 molecular transmission networks. The overall prevalence of PDR was 7.6% and that of PDR to non-nucleotide reverse transcriptase inhibitors was 6.1%. Of three transmission networks for PDR, two were closely associated with Beijing and Tianjin, while another was restricted to sequences determined in this study. Conclusions These results demonstrate that during acute HIV-1 infection, PDR is transmitted in dynamic networks. This suggests that early detection, diagnosis, surveillance, and treatment are critical to effectively control HIV-1 spread.

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HIV-1 Genetic Diversity and High Prevalence of Pretreatment Drug Resistance in Tianjin, China

Cited by 18 publications

References 17 publications

Pre‐treatment and acquired antiretroviral drug resistance among people living with HIV in Tianjin, China

Pre‐treatment and acquired antiretroviral drug resistance among people living with HIV in Tianjin, China

Survey of pretreatment HIV drug resistance and the genetic transmission networks among HIV-positive individuals in southwestern China, 2014–2020

Molecular transmission networks and pre-treatment drug resistance among individuals with acute HIV-1 infection in Baoding, China

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