Lan Yun, Deng Xizi, Li Linghua, Cai Weiping, Li Junbin, Cai Xiaoli, Li Feng, Hu Fengyu, Lei Chunliang, Tang Xiaoping
Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangzhou, 510030, People's Republic of China.
Infect Drug Resist. 2021 Aug 4;14:2977-2989. doi: 10.2147/IDR.S317187. eCollection 2021.
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.
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.
HIV-1 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.
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.
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.
广东位于中国南部，是中国受HIV-1严重影响的地区之一。在广东，男男性行为者（MSM）中HIV-1的传播呈逐渐上升趋势。
调查2014年至2019年广东接受抗逆转录病毒治疗（ART）失败的MSM中HIV-1耐药特征及基因传播网络。
扩增HIV-1基因序列。使用在线分型工具确定基因型，并重建最大似然系统发育树以确认基因型结果。利用斯坦福大学HIV耐药数据库分析耐药突变（DRM）序列和耐药谱。采用基于Tamura-Nei 93双参数遗传距离的方法分析基因传播网络。
在从接受ART治疗失败的HIV感染MSM中分离出的393个序列中，CRF01_AE（47.3%）、CRF07_BC（21.4%）和CRF55_01B（21.4%）是前三大毒株。55.2%的个体携带核苷类逆转录酶抑制剂（NRTI）DRM，而67.4%携带非核苷类逆转录酶抑制剂（NNRTI）DRM。96.8%的病例携带对NRTIs或NNRTIs高水平耐药的突变。最常见的DRM是M184I/V（42.2%），其次是V179D/E（37.9%）和K65R（27.2%）。在B亚型序列中，没有序列聚为一簇。在CRF01_AE、CRF55_01B和CRF59_01B序列中，分别有14.5%、61.9%和33.3%聚为一簇。在CRF07_BC序列中，39.3%聚为一簇。传播网络中的大多数MSM集中在35岁以下，且存在多个联系。此外，约54.8%的MSM有超过2个潜在传播伙伴。
在广东省接受ART治疗失败的MSM中，NNRTIs耐药突变更频繁发生。传播网络分析揭示了复杂的传播模式，应更加关注有多个联系的年轻HIV-1感染MSM。
