Prevalence of transmitted HIV-1 drug resistance among treatment-naive individuals in China, 2000-2016

Abstract

HIV with transmitted drug-resistance (TDR) limits the therapeutic options available for treatment-naive HIV patients. This study aimed to further our understanding of the prevalence and transmission characteristics of HIV with TDR for the application of rst-line antiretroviral regimens. A total of 6578 HIV-1 protease/reverse-transcriptase sequences from treatment-naive individuals in China between 2000 and 2016, were obtained from the Los Alamos HIV Sequence Database and were analyzed for TDR. Transmission networks were constructed to determine genetic relationships. The spreading routes of large TDR clusters were identi ed using a Bayesian phylogeographic framework. TDR mutations were detected in 274 (4.51%) individuals, with 1.40% harboring TDR to nucleoside reverse transcriptase inhibitors, 1.52% to non-nucleoside reverse transcriptase inhibitors, and 1.87% to protease inhibitors. The most frequent mutation was M46L (58, 0.89%), followed by K103N (36, 0.55%), M46I (36, 0.55%), and M184V (26, 0.40%). The prevalence of total TDR initially decreased between 2000 and 2010 (OR = 0.83, 95% CI 0.73-0.95), and then increased thereafter (OR = 1.50, 95% CI 1.13-1.97). The proportion of sequences in a cluster (clustering rate) among HIV with TDR sequences was lower than that of sequences without TDR (40.5% vs. 48.8%, P = 0.023) and increased from 27.3% in 2005-2006 to 63.6% in 2015-2016 (P < 0.001). While most TDR mutations were associated with reduced relative transmission tness, mutation M46I was associated with higher relative transmission tness than the wild-type strain.This study identi ed a low-level prevalence of TDR HIV in China during the last two decades. However, the increasing TDR HIV rate sicn 2010, the persistent circulation of drug resistance mutations, and the expansion of self-sustaining drug resistance reservoirs may compromise the e cacy of antiretroviral therapy programs.

Factors Associated With Newly HIV Infection and Transmitted Drug Resistance Among Men Who Have Sex With Men in Harbin, P.R. China

“…The TDR of HIV in MSM in Harbin was 4.08%, consistent with the studies among MSM in China (3.1%), Kunming (5%), Guangxi (4.8%), Jiangsu (4.0%), Guangdong (3.32%) ( 18 , 21 , 24 – 26 , 35 ), lower than the TDR among MSM in Tianjin (6.3%) ( 27 ), but higher than the TDR among MSM in Xi'an (2.4%) ( 23 ). The prevalence of HIV−1 TDR was relatively low among MSM in Heilongjiang province, which suggests that current strategies of treatment are effective in MSM in Heilongjiang province.…”

“…The prevalence of HIV−1 TDR was relatively low among MSM in Heilongjiang province, which suggests that current strategies of treatment are effective in MSM in Heilongjiang province. Prevalence of mutations related to NNRTI resistance were higher in the study, which might be attributed to lower genetic barriers to NNRTI resistance, or the use of first–line regimen ( 18 , 36 ). In our survey, the major HIV genotype in MSM in Harbin was CRF01_AE, accounting for half of the samples.…”

“…Attention should be paid to the transmission of drug-resistant HIV among MSM because of high-risk behaviors, and high levels of viremia in MSM during the recent infection stage ( 17 ). Previous studies have shown that prevalence of HIV TDR in China was low during the last two decades ( 18 – 20 ). Many studies have reported the prevalence of TDR among MSM in China, ranging from 2.4% to 6.3% ( 21 – 27 ).…”

Practice and Prospect: HIV-1 Molecular Network-Based Studies in China

“…Nationwide studies have shown that the clustering rate of drug-resistant strains is lower than that of sensitive strains 36,37 ; however, the clustering rate of pre-treatment drug resistance increased significantly from 27.3% (2005-2006) to 63.6% (2015-2016). 37 Other studies reported using molecular networks to monitor the transmission of strains with drug resistance, such as in Shanghai, 38 Hebei, 39,40 Tianjin, 41 Sichuan, [42][43][44] Yunnan, 45 and Guangxi. 46 A recent study showed that a rapidly growing cluster with E138Q and V179D mutations was identified in Liangshan (Sichuan Province).…”

Medicinal Fungi with Antiviral Effect

“…The genome of HIV consists of two identical positive strands of RNA, with a total length of about 9.7 kilobase pairs. Antiretroviral therapy (ART) for HIV-1 infection is the main treatment for AIDS at present, which significantly reduces the morbidity and mortality associated with HIV/AIDS, but the problem of drug resistance still needs to be solved [ 116 ].…”