Relatively High Prevalence of Drug Resistance Among Antiretroviral-Naive Patients from Henan, Central China

Abstract

To elucidate the prevalence of HIV-1 subtypes and transmitted drug resistance in Henan, central China, HIV-1-positive blood samples from 187 antiretroviral-naive patients were collected in our study from August 2009 to November 2010. Subtype B¢ (92.0%, 172 of 187) remains the predominant HIV-1 subtype in Henan province and was prevalent in all risk populations and geographic regions. Of 98 pol sequences 67 (68.4%) harbored drug resistance mutations, and only 14 (14.3%, 14 of 98) sequences have mutations associated with significantly reduced phenotypic susceptibility to antiretroviral drugs. The unexpectedly high percentage of drug resistance in Henan province is mainly due to the prevalence of minor mutations in the protease and integrase regions, especially A71T/V and L68V/I/IM/LV. In all, we detected a relatively high prevalence of drug resistance with unique mutation distributions among antiretroviral-naive patients from Henan province.

Prevalence of Transmitted HIV-1 Drug Resistance Remains Low in Guangxi, China, Eight Years after Scale-Up of Highly-Active Antiretroviral Therapy

“…Another study from Guangdong province showed that the prevalence of TDR was 6.7% after 5 years of the scale-up [20]. A report from Henan province, the first province to provide free ARV to HIV-infected individuals in 2003 in China, shows that the prevalence of TDR in the province is 14.3%, 8 years after the scale-up [21]. The difference in the prevalence of TDR between Guangxi and Henan provinces is significant (χ 2 = 13.178, p < 0.001), although the period from scale-up to sample collection is the same.…”

Short Communication: Increase of HIV-1 K103N Transmitted Drug Resistance and Its Association with Efavirenz Use in South Korea

“…23,24 However, we found a distinct clustering of Chinese subtype B strains (GenBank accession numbers KC988120-KC988159 23 ) from those from South Korea in phylogenetic analysis and none of our K103N TDR strains was genetically related to the Chinese subtype B strains (data not shown). Therefore, we believe that the increasing prevalence of K103N TDR is likely a consequence of the widespread use of NNRTI in South Korea in the past decade as observed in other areas.…”

Sequencing of Gag/Env association with HIV genotyping resolution and HIV-related epidemiologic studies of HIV in China

“…However, the high cost of whole-genome sequencing has limited its usage, and thus sequencing of focused genomic regions, such as the Gag, Pol, Env, and Vpr genes or a combination of different gene fragments, is viewed as a relatively cost-effective alternative (Preston et al, 1988;Mansky and Temin, 1995;Lan et al, 2008;Chen et al, 2011;Chen et al, 2012). Three structural genes (Chen et al, 2011) [Gag (Yao et al, 2012;Ye et al, 2012), Env (Pang et al, 2012;Ye et al, 2012;Li et al, 2014a) and Pol (Holguín et al, 2008;Chen et al, 2014;Yan et al, 2015)] have been widely used for genotyping HIV. Previous studies led to the classification of HIV into two main types, HIV-1 and HIV-2 (Zhang et al, 2015), with HIV-1 being the predominant branch.…”

“…For example, one patient was reported to be infected with subtype C based on sequencing of the Pol gene and the p17 fragment of Gag gene; however, the same individual was classified as CRF07_BC with the p24 fragment of the Gag gene, as well as subtype B with the Vpu gene (Robertson et al, 2000;Chen et al, 2013). To avoid such discrepancies, simultaneous analysis of different gene fragments, such as Gag/Env Chen et al, 2013), Gag/Pol (Yao et al, 2012), Pol/Env (Chen et al, 2012;Pang et al, 2012), and Gag/Pol/ Env (Lan et al, 2008;Ye et al, 2012;Zeng et al, 2012;Li et al, 2014a;Dai et al, 2015), will facilitate the clear identification of potential new inter-subtype recombinants. However, the field still lacks a set of standard markers for identifying HIV strains, which precludes inter-study comparisons and hampers the comprehensive understanding of the panorama of HIV infection.…”

“…Rather, many groups have opted to sequence single genes or combinations of two or three genes to reduce costs. In this regard, the eight markers Env, Gag, Pol, Vpr, Gag/Env, Gag/Pol, Pol/Env, and Gag/Pol/Env have often been used to subtype HIV in China (Lan et al, 2008;Chen et al, 2012;Pang et al, 2012;Yao et al, 2012;Ye et al, 2012;Zeng et al, 2012;Li et al, 2014a;Dai et al, 2015). However, the high mutation and recombination rates associated with the HIV genome (Robertson et al, 1995;Robertson et al, 2000), have led to ambiguous and sometimes contradictory genotyping results, even in the same individual (Robertson et al, 2000;Qiu et al, 2005;Chen et al, 2013).…”