Transmitted drug resistance and transmission clusters among ART-naïve HIV-1-infected individuals from 2019 to 2021 in Nanjing, China

Frontiers in Public Health

Public Health

Chengyuan Ding¹  Sushu Wu²  Zhengping Zhu²  Yuanyuan Xu²  Xin Li²  Hongjie Shi²  Xiaoshan Li³  Hongying Zhang⁴  Mengkai Qiao⁴  Xiaoxiao Dong⁴ 

[1]Center for Global Health, School of Public Health, Nanjing Medical University, Nanjing, China

[2]Department of AIDS/STD Control and Prevention, Nanjing Center for Disease Control and Prevention, Nanjing, China

[3]Department of Lung Transplant Center, The Affiliated Wuxi People’s Hospital of Nanjing Medical University, Wuxi People’s Hospital, Wuxi Medical Center, Nanjing Medical University, Wuxi, China

[4]Department of Microbiology Laboratory, Nanjing Center for Disease Control and Prevention, Nanjing, China

关键词: HIV;    transmitted drug resistance;    mutations;    transmission cluster;    antiretroviral therapy;   

DOI  :  10.3389/fpubh.2023.1179568

 received in 2023-03-04, accepted in 2023-04-11,  发布年份 2023

来源: Frontiers

【 摘 要 】

BackgroundTransmitted drug resistance (TDR) is an increasingly prevalent problem worldwide, which will significantly compromise the effectiveness of HIV treatments. However, in Nanjing, China, there is still a dearth of research on the prevalence and transmission of TDR among ART-naïve HIV-1-infected individuals. This study aimed to understand the prevalence and transmission of TDR in Nanjing.MethodsA total of 1,393 participants who were newly diagnosed with HIV-1 and had not received ART between January 2019 and December 2021 were enrolled in this study. HIV-1 pol gene sequence was obtained by viral RNA extraction and nested PCR amplification. Genotypes, TDR and transmission cluster analyses were conducted using phylogenetic tree, Stanford HIV database algorithm and HIV-TRACE, respectively. Univariate and multivariate logistic regression analyses were performed to identify the factors associated with TDR.ResultsA total of 1,161 sequences were successfully sequenced, of which CRF07_BC (40.6%), CRF01_AE (38.4%) and CRF105_0107 (6.3%) were the main HIV-1 genotypes. The overall prevalence of TDR was 7.8%, with 2.0% to PIs, 1.0% to NRTIs, and 4.8% to NNRTIs. No sequence showed double-class resistance. Multivariate logistic regression analysis revealed that compared with CRF01_AE, subtype B (OR = 2.869, 95%CI: 1.093–7.420) and female (OR = 2.359, 95%CI: 1.182–4.707) were risk factors for TDR. Q58E was the most prevalent detected protease inhibitor (PI) -associated mutation, and V179E was the most frequently detected non-nucleoside reverse transcriptase inhibitor (NNRTI) -associated mutation. A total of 613 (52.8%) sequences were segregated into 137 clusters, ranging from 2 to 74 sequences. Among 44 individuals with TDR (48.4%) within 21 clusters, K103N/KN was the most frequent TDR-associated mutation (31.8%), followed by Q58E/QE (20.5%) and G190A (15.9%). Individuals with the same TDR-associated mutations were usually cross-linked in transmission clusters. Moreover, we identified 9 clusters in which there was a transmission relationship between drug-resistant individuals, and 4 clusters in which drug-resistant cases increased during the study period.ConclusionThe overall prevalence of TDR in Nanjing was at a moderate level during the past 3 years. However, nearly half of TDR individuals were included in the transmission clusters, and some drug-resistant individuals have transmitted in the clusters. Therefore, HIV drug-resistance prevention, monitoring and response efforts should be sustained and expanded to reduce the prevalence and transmission of TDR in Nanjing.

【 授权许可】

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Copyright © 2023 Xu, Shi, Dong, Ding, Wu, Li, Zhang, Qiao, Li and Zhu.