New Trends of Primary Drug Resistance Among HIV Type 1-Infected Men Who Have Sex with Men in Liaoning Province, China

Abstract

To elucidate the recent changes in prevalence of HIV-1 primary resistance mutations in men who have sex with men (MSM) in Liaoning province, 217 samples from antiretroviral therapy-naive MSM were collected. For 201 samples, the entire protease gene and 256 amino acids of the reverse transcriptase gene were successfully amplified by reverse transcriptase polymerase chain reaction (RT-PCR) and nested PCR of viral RNA and were sequenced. Among the amplified pol sequences, HIV-1 CRF01_AE accounted for 87.6% (176/201), subtype B accounted for 8.0% (16/201), and subtype CRF07_BC accounted for 4.5% (9/201). The overall prevalence of mutations conferring resistance to any drug was 4.5%, representing 4.5% for protease inhibitor (PI)-related mutations, 0.5% for nucleoside/nucleotide reverse transcriptase inhibitor (NRTI)-related mutations, and 0.5% for nonnucleoside reverse transcriptase inhibitor (NNRTI)-related mutations. Included were V32I (0.5%), M46I (2.0%), L90M (2.0%), T215C (0.5%), and Y188L (0.5%). Only one case carried resistance mutations to all three drug classes (L90M, L10I, and A71T to PI; T215C to NRTI; and Y188L to NNRTI). L10I (4.5%), V118I/IV (17.4%), and K103R/KR (10.0%) were commonly observed mutations, but do not confer any drug resistance to PIs, NRTIs, and NNRTIs. CRF01_AE is becoming a major HIV-1 infection subtype among MSM of Liaoning province. Relatively high rates of HIV drug-resistant mutations to PIs in antiretroviral treatment-naive patients in the study represent a serious challenge for future HIV treatment programs in China.

Transmitted Antiretroviral Drug Resistance in the Men Who Have Sex with Men HIV Patient Cohort, Beijing, China, 2008–2011

“…On the contrary, TDR related to NNRTI and NRTI were much less frequent. Previous studies had similar findings (12,13,19). Lin Li et al found four cases carrying a TDR mutation in 76 strains among Beijing MSM patients.…”

“…The HIV drug resistance (HIVDR) Surveillance Network of China reported that TDR was low (<5%) to all drug classes used since 2007, except for one study that showed moderate (5-15%) rates of transmitted PIs in 2009 (12). The TDR rate in naive MSM patients in the Liaoing province in China was reported to be 4.5%, representing 4.5% for PI-related mutations, 0.5% for NRTIrelated mutations, and 0.5% for NNRTI-related mutations (201 patients, 2003-2009) (19). Another study by Lin Li et al reported a TDR rate of 5.3% among naive MSM patients in Beijing (95 patients, 2007-2010) (13).…”

“…All the patients belong to the MSM cohorts at the You'an hospital, Beijing, China, between 2008 and 2011, who were enrolled in the AIDS High Risk Cohort Program clinics. This program is supported by the Beijing Science and Technology Committee (6,19). Started in October 2006, more than 2,000 MSM had been enrolled by way of introduction to each other into the longitudinal prospective cohort study.…”

Transmitted Antiretroviral Drug Resistance and Thumb Subdomain Polymorphisms Among Newly HIV Type 1 Diagnosed Patients Infected with CRF01_AE and CRF07_BC Virus in Guangdong Province, China

“…The overall prevalence of TDR was 6.7% (8/119), representing 7.1% (6/84) for CRF01_AE and 5.7% (2/35) for CRF07_BC, even though the patients had never been exposed to ARVs. In previous surveys of HIV-1 drug resistance, a TDR prevalence rate of 4.5% was found in 217 samples from ARV therapy-naive MSM in Liaoning 6 ; in a nationwide investigation on TDR in ARV therapy-naive patients in China, 2 the prevalence rate was found to be 3.8%. However, the TDR prevalence rates in the present study were relatively higher.…”

“…6 However, TDR was also detected among therapynaive patients in other Asian countries. In Japan, the prevalence of TDR increased from 5.9% in 2003 to 8.3% in 2008 in therapy-naive HIV-1 patients 7 ; it increased to 5% in Vietnam,8 3% in Korea, 9 and 4.3% in South Korea.…”