Characterization of HIV-1 subtypes and drug resistance mutations in Henan Province, China (2017–2019)

Abstract

Human immunodeficiency virus type 1 (HIV-1) infection remains a severe public health problem worldwide. In this study, we investigated the distribution of HIV-1 subtypes and the prevalence of drug resistance mutations (DRMs) among patients with HIV-1 infection in Henan Province, China. HIV-1 strains in blood samples taken from inpatients and outpatients visiting the Sixth People's Hospital of Zhengzhou from August 2017 to July 2019 with a viral load (VL) greater than 1000 copies/ ml were subjected to subtype and DRMs analysis. Out of a total of 769 samples, subtype and DRM data were obtained from 657 (85.43%) samples. Phylogenetic analysis based on partial pol gene sequences indicated that the most commonly found genotype was subtype B (45.51%, 299/657), followed by CRF01_AE (28.61%, 188/657), CRF07_BC (15.68%, 103/657), CRF08_BC (0.76%, 5/657), C (0.61%, 4/657), A (0.30%, 2/657), and others (8.52%, 56/657). Circulating recombinant forms (CRFs) were most commonly found in patients who were naïve to antiretroviral treatment (ART) (68.67%, 160/233). The percentage of patients with one or more major drug-resistance mutations was 50.99% (335/657), and it was 6.44% (15/233) in ART-naive patients that were primarily infected with subtype B (17.74%). Resistance mutations were most common at codons 65, 103, 106, 184, and 190 of the reverse transcriptase gene and codon 46 of the protease gene. Our study provides detailed information about the distribution of HIV-1 subtypes and the incidence of drug resistance mutations of different subtypes in ART-experienced and naïve patients. This can guide policymakers in making decisions about treatment strategies against HIV-1.

Drug resistance mutations among people living with HIV with treatment failure in Henan Province, China

“…Phylogenetic analysis based on the determined partial pol gene sequences indicated that the most common subtype was B, which accounted for 59.5%, followed by CRF01_AE, CRF07_BC, CRF55_01B, and CRF08_BC, which is consistent with subtype patterns in other regions [3,4] and our previous study. [1] Our data showed that the incidence of DRMs was 81.2% (748/921), which is consistent with the incidence worldwide (47-90%); however, it was significantly higher than that of 52-57% reported previously in China. [5] This might be explained by historical reasons as Henan province harbored the earliest group of PLWH due to illicit blood donation.…”

Evaluation of a Novel In-house HIV-1 Genotype Drug Resistance Assay using Clinical Samples in China

“…It was reported that HIV-1 circulating subtype in China was identified, including CRF01_AE, subtype B, CRF07_BC, and CRF08_BC, [ 43 , 51 - 58 ] as well as the novel HIV-1 CRFs [ 38 , 59 - 64 ] (CRF55_01B [ 65 ], CRF59_01B [ 66 ], etc ). So, the ability to detect mutations on diversified HIV-1 subtypes is necessary for HIV-1 drug resistance assays.…”

Prevalence of transmitted drug resistance mutations among patients infected with human immunodeficiency virus type 1 (HIV-1) in Henan Province, China

“…Furthermore, whole blood samples were collected and HIV-1 partial pol gene and complete integrase gene sequences were separately amplified, sequenced, and analyzed for drug resistance mutations (DRMs), as described previously. [ 1 , 2 ] DRMs and antiretroviral susceptibility were analyzed by submitting the determined sequences to the regularly updated Stanford HIV-1 drug resistance database ( http://hivdb.stanford.edu/ ). Subtyping of HIV isolates was performed using the REGA HIV-1 Subtyping Tool ( http://dbpartners.stanford.edu:8080/RegaSubtyping/stanford-hiv/typingtool/ ) based on the partial pol region, which was further confirmed by phylogenetic analysis.…”

“…In our previous study, DRMs were most commonly observed in B, the dominant subtype in treatment-experienced patients. [ 2 ] The discrepancy between TDRMs in treatment-naive and DRMs in treatment-experienced patients might be due to historical reasons. However, along with social and economic improvements, the number of patients infected with subtype B is expected to continue to decrease.…”

“…Demographic data and medical records, including HIV ribonucleic acid (RNA) viral load (VL), CD4 + T-cell count, and transmission route, were collected. Furthermore, whole blood samples were collected and HIV-1 partial pol gene and complete integrase gene sequences were separately amplified, sequenced, and analyzed for drug resistance mutations (DRMs), as described previously [1,2] . DRMs and antiretroviral susceptibility were analyzed by submitting the determined sequences to the regularly updated Stanford HIV-1 drug resistance database (http://hivdb.stanford.edu/).…”