New trends of primary drug resistance among HIV-1 infected men who have sex with men in Liaoning province, China.

Published: March 18, 2011

To elucidate the recent changes in prevalence of HIV-1 primary resistance mutations in men who have sex with men (MSM) in Liaoning province. In total, 217 samples from antiretroviral therapy-naïve MSM were collected. For 201 samples, the entire protease gene and 256 amino acids of the reverse transcriptase gene were successfully amplified by RT-PCR and nested PCR of viral RNA and were sequenced. Among the amplified pol sequences, HIV-1 CRF01_AE accounted for 87.6% (176/201), subtype B accounted for 8.0% (16/201) and subtype CRF07_BC accounted for 4.5% (9/201). Overall prevalence of mutations conferring resistance to any drug was 4.5%, representing 4.5% for protease inhibitor (PI) related mutations, 0.5% for nucleoside/nucleotide reverse transcriptase inhibitor (NRTI) related mutations, and 0.5% for non-nucleoside reverse transcriptase inhibitor (NNRTI) related mutations. Included were V32I (0.5%), M46I (2.0%), L90M (2.0%), T215C (0.5%) and Y188L (0.5%). Only one case carried resistance mutations to all three drug classes (L90M, L10I, and A71T to PI; T215C to NRTI; and Y188L to NNRTI). L10I (4.5%), V118I/IV (17.4%) and K103R/KR (10.0%) were commonly observed mutations, but do not confer any drug resistance to PI, NRTI and NNRTI. CRF01_AE is becoming a major HIV-1 infection subtype among MSM of Liaoning province, Relatively high rates of HIV drug-resistant mutations to PI in ART-naïve patients in the study represent a serious challenge for the future HIV treatment programs in China

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