HIV-1 Drug Resistance and Genetic Transmission Networks Among MSM Failing Antiretroviral Therapy in South China 2014-2019

Yun Lan; Xizi Deng; Linghua Li; Weiping Cai; Junbin Li; Xiaoli Cai; Feng Li; Fengyu Hu; Chunliang Lei; Xiaoping Tang

doi:10.2147/IDR.S317187

HIV-1 Drug Resistance and Genetic Transmission Networks Among MSM Failing Antiretroviral Therapy in South China 2014-2019

Infect Drug Resist. 2021 Aug 4:14:2977-2989. doi: 10.2147/IDR.S317187. eCollection 2021.

Authors

Yun Lan^#¹, Xizi Deng^#¹, Linghua Li¹, Weiping Cai¹, Junbin Li¹, Xiaoli Cai¹, Feng Li¹, Fengyu Hu¹, Chunliang Lei¹, Xiaoping Tang¹

Affiliation

¹ Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, 510030, People's Republic of China.

^# Contributed equally.

Abstract

Background: Guangdong, located in South China, is one of the areas heavily affected by HIV-1 in China. The transmission of HIV-1 among men who have sex with men (MSM) has gradually been increasing in Guangdong.

Objective: To investigate the characteristics of the HIV-1 drug resistance, and genetic transmission networks in MSM with antiretroviral therapy (ART) failure from 2014 to 2019 in Guangdong.

Methods: HIV-1 pol gene sequences were amplified. An online subtyping tool was used to determine the genotype, and a maximum likelihood phylogenetic tree was reconstructed to confirm the genotype results. The Stanford University HIV Drug Resistance Database was used to analyse the sequences of drug resistance mutations (DRMs) and drug resistance profiles. A pairwise Tamura-Nei 93 genetic distance-based method was used to analyse the genetic transmission networks.

Results: Of 393 sequences isolated from HIV-infected MSM with ART failure, CRF01_AE (47.3%), CRF07_BC (21.4%) and CRF55_01B (21.4%) were the top three strains. 55.2% individuals harboured NRTI DRMs, whereas 67.4% carried NNRTI DRMs. 96.8% cases harboured mutations resistance to NRTIs or NNRTIs at high-level. The most common DRMs were M184I/V (42.2%), followed by V179D/E (37.9%) and K65R (27.2%). Of the subtype B sequences, no sequence fell into a cluster. Of the CRF01_AE, CRF55_01B, and CRF59_01B sequences, 14.5%, 61.9%, and 33.3% fell into clusters, respectively. Of the CRF07_BC sequences, 39.3% fell into clusters. The majority of MSM in transmission networks were concentrated at age below 35 years old, with multiple links. Moreover, approximately 54.8% of MSM had more than 2 potential transmission partners.

Conclusion: Drug resistance mutations more frequently occurred in NNRTIs among MSM with ART failure in Guangdong Province. Transmission network analysis revealed a complex transmission pattern, and more attention should be given to younger HIV-1-infected MSM with multiple links.

Keywords: HIV-1; MSM; drug resistance; genetic transmission networks.

Grants and funding

This study was supported by grants from the National Major Scientific and Technological Special Project during the 13th Five-Year Plan Period (2017ZX10202101-003), the Joint-Innovative Program in Healthcare for Special Scientific Research Projects of Guangzhou (201803040002), and Guangzhou Science and Technology Plan Project (202002030028).