Genetic diversity and drug resistance among newly diagnosed and antiretroviral treatment-naive HIV-infected individuals in western Yunnan: a hot area of viral recombination in China

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• 作者：Min Chen (1)
  Yanling Ma (1)
  Song Duan (2)
  Hui Xing (3)
  Shitang Yao (2)
  Yingzhen Su (1)
  Hongbing Luo (1)
  Li Yang (1)
  Huichao Chen (1)
  Liru Fu (1)
  Aijuan Qu (4)
  Chin-Yih Ou (5)
  Manhong Jia (1)
  Lin Lu (1)
  
• 关键词：HIV ; 1 ; Genetic diversity ; Drug resistance ; Injecting drug use ; Dehong ; China
• 刊名：BMC Infectious Diseases
• 出版年：2012
• 出版时间：December 2012
• 年：2012
• 卷：12
• 期：1
• 全文大小：357KB
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  31. The pre-publication history for this paper can be accessed here:http://www.biomedcentral.com/1471-2334/12/382/prepub
  
• 作者单位：Min Chen (1)
  Yanling Ma (1)
  Song Duan (2)
  Hui Xing (3)
  Shitang Yao (2)
  Yingzhen Su (1)
  Hongbing Luo (1)
  Li Yang (1)
  Huichao Chen (1)
  Liru Fu (1)
  Aijuan Qu (4)
  Chin-Yih Ou (5)
  Manhong Jia (1)
  Lin Lu (1)
  
  1. Yunnan Center for AIDS/STD Control and Prevention, Yunnan Center for Disease Control and Prevention, Kunming, Yunnan, 650022, China
  2. Department of HIV/AIDS Control and Prevention, Dehong Center for Disease Control and Prevention, Dehong, Yunnan, 678400, China
  3. National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, 102206, China
  4. Laboratory of Metabolism, Center for Cancer Research National Cancer Institute, National Institutes of Health, Bethesda, MD, 20892, USA
  5. Global AIDS Program in China, U. S. Centers for Disease Control and Prevention, Beijing, 100600, China
  

文摘

Background The emergence of an HIV-1 epidemic in China was first recognized in Dehong, western Yunnan. Due to its geographic location, Dehong contributed greatly in bridging HIV-1 epidemics in Southeast Asia and China through drug trafficking and injection drug use; and also extensively to the HIV genetic diversity in Yunnan and China. We attempt to monitor HIV-1 in this area by studying the HIV-1 genetic distribution and transmitted drug resistance (TDR) in various at-risk populations. Methods Blood samples from a total of 320 newly HIV-1 diagnosed individuals, who were antiretroviral therapy (ART)-naive, were collected from January 2009 to December 2010 in 2 counties in Dehong. HIV-1 subtypes and pol gene drug resistance (DR) mutations were genotyped. Results Among 299 pol sequences successfully genotyped (93.4%), subtype C accounted for 43.1% (n=129), unique recombinant forms (URFs) for 18.4% (n=55), CRF01_AE for 17.7% (n=54), B for 10.7% (n=32), CRF08_BC for 8.4% (n=25) and CRF07_BC for 1.7% (n=5). Subtype distribution in patients infected by different transmission routes varied. In contract to the previous finding of CRF01_AE predominance in 2002-2006, subtype C predominated in both injecting drug users (IDUs) and heterosexually transmitted populations in this study. Furthermore, we found a high level of BC, CRF01_AE/C and CRF01_AE/B/C recombinants suggesting the presence of active viral recombination in the area. TDR associated mutations were identified in 4.3% (n=13) individuals. A total of 1.3% of DR were related to protease inhibitors (PIs), including I85IV, M46I and L90M; 0.3% to nucleoside reverse transcriptase inhibitors (NRTIs), including M184I; and 2.7% to non-nucleoside reverse transcriptase inhibitors (NNRTIs), including K103N/S, Y181C, K101E and G190A. Conclusion Our work revealed diverse HIV-1 subtype distributions and intersubtype recombinations. We also identified a low but significant TDR mutation rate among ART-naive patients. These findings enhance our understanding of HIV-1 evolution and are valuable for the development and implementation of a comprehensive public health approach to HIV-1 DR prevention and treatment in the region.