HIV-1 subtype diversity, drug resistance, and genetic transmission networks in men who have sex with men with virologic failure in antiretroviral therapy in Sichuan, China, 2011 to 2017

Dan Yuan; Zonglun Du; Junmin Zhou; Li Ye; Ling Su; Hong Yang; Fengshun Yuan; Yiping Li; Honglu Liu; Wenwen Zhai; Shu Liang; Shujuan Yang

doi:10.1097/MD.0000000000017585

HIV-1 subtype diversity, drug resistance, and genetic transmission networks in men who have sex with men with virologic failure in antiretroviral therapy in Sichuan, China, 2011 to 2017

Medicine (Baltimore). 2019 Oct;98(43):e17585. doi: 10.1097/MD.0000000000017585.

Authors

Dan Yuan¹, Zonglun Du², Junmin Zhou³, Li Ye¹, Ling Su¹, Hong Yang¹, Fengshun Yuan¹, Yiping Li¹, Honglu Liu¹, Wenwen Zhai³, Shu Liang¹, Shujuan Yang³

Affiliations

¹ Center for AIDS/STD Control and Prevention, Sichuan Center for Disease Control and Prevention.
² School of Optoelectronic Science and Engineering, University of Electronic Science and Technology of China.
³ West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China.

Abstract

This study sought to examine the human immunodeficiency virus type 1 (HIV-1) genetic diversity on drug resistance among men who have sex with men (MSM) with virologic failure in antiretroviral therapy (ART), and investigate linking-associated factors for genetic transmission networks.Seven hundred and thirty-four HIV-positive MSM with virologic failure in ART were recruited into our study from 2011 to 2017. HIV-1 pol gene sequences were used for phylogenetic and genotypic drug resistance analyses. The drug resistance mutations were determined using the Stanford University HIV Drug Resistance Database. The genetic transmission networks were analyzed for CRF01_AE and CRF07_BC sequences by the genetic distance-based method.Of 734 subjects, 372 (50.68%) showed drug resistance, in which CRF01_AE and CRF07_BC were the predominating subtypes. Drug resistance more frequently occurred in non-nucleoside reverse transcriptase inhibitors (NNRTIs) treatment (48.64%), and followed by nucleoside reverse transcriptase inhibitors (NRTIs) (36.51%) and PIs (4.03%). The most common drug resistance-associated mutations in protease inhibitors (PIs), NRTIs and NNRTIs were K20I/R, M184V/I and K103N/KN, respectively. For 283CRF01_AE sequences, 64 (22.61%) fell into clusters at a genetic distance of 0.011, resulting in 17 clusters ranging in size from 2 to 16 individuals. For 230 CRF07_BC sequences, 66 (28.69%) were connected to at least one other sequence with 0.005 genetic distances, resulting in 8 clusters ranging in size from 2 to 52 individuals. Individuals who showed drug resistance to ART were less likely to fall into clusters than those who did not. The genetic linkage was robust by the exclusion of sites associated with drug resistance.CRF01_AE and CRF07_BC were the main strains among MSM with virologic failure in ART, and the drug resistance more frequently occurred in NNRTIs, followed by NRTIs and PIs. Genetic transmission networks revealed a complexity of transmission pattern, suggesting early-diagnosis and in-time intervention among MSM.

MeSH terms

Adolescent
Adult
Anti-HIV Agents / adverse effects*
China
Drug Resistance, Viral / genetics*
HIV Infections / drug therapy*
HIV-1 / genetics*
Homosexuality, Male
Humans
Male
Reverse Transcriptase Inhibitors / adverse effects*
Sexual and Gender Minorities / statistics & numerical data
Treatment Failure
Young Adult

Substances

Anti-HIV Agents
Reverse Transcriptase Inhibitors