Diversity of HIV-1 subtypes and primary HIV-1 drug resistance among 302 newly confirmed HIV infections/AIDS in Henan province, China

Abstract

To investigate HIV-1 subtype diversity and the frequency of primary drug resistance in newly confirmed HIV infections/AIDS, and the ratio of recently infected cases in Henan. Newly confirmed HIV infections/AIDS from June 2013 to October 2013 and from June 2014 to October 2014 in the municipal CDC and county CDC of six cities in Henan province (Nanyang, Luohe, Pingdingshan, Shangqiu, Xuchang and Zhengzhou) were included in this study. Information on demographics, route of infection and antiviral therapy regimen were obtained from report cards, and at follow-up visits. After collection of blood samples from 402 individuals for confirmatory diagnostic tests, 100 were excluded because of hemolysis or insufficient samples in 11 cases, and incomplete amplification results in 89 cases. Recent HIV infection was determined by the BED capture immunoassay. An in-house method were used for genotypic drug resistance tests and sequence analysis. Among the 302 individuals included, the mean age was (44.0±15.5) years, and 160 (53.0%) and 142 (47.0%) cases were confirmed in 2013 and 2014, respectively. The ratio of recent infections was 29.5% (89 cases), inside, the ratio of recent infections were 31.3% (20/64), 40.5% (30/74), 21.3% (32/150), 3/8 and 4/6 in 01_AE, 07_BC, B, 01_B and other subtypes (B/C, C, 01_BC and 08_BC) (χ(2)=13.48, P=0.009). The frequency of the B subtype was higher in former infections, at 55.4% (118/213), than in recent infections, at 36% (32/89) (χ(2)=9.49, P=0.002). In contrast, the ratios of both 07_BC and other subtypes were lower in former infections (20.7% (44/213) and 1% (2/213), respectively) than recent infections (33.7% (30/89), χ(2)=5.78, P=0.016 and 5% (4/89), χ(2)=4.08; P=0.044, respectively). The frequency of primary HIV-1 drug resistance was 6.0% (18 cases) in 302 subjects. The frequency of resistance to nucleoside reverse transcriptase inhibitor (NRTI) and non-nucleoside reverse transcriptase inhibitor (NNRTI) drugs was 2.7% (8 cases) and 3.6% (11 cases), respectively. Primary HIV-1 drug resistance was more frequent in subtypes B and 07_BC, at 8.7% (13 cases) and 5.4% (4 cases), respectively. Newly confirmed HIV infections/AIDS in Henan province harbored certain proportion of none-B subtypes, the frequency of primary resistance tended to be high in HIV-1B infection. The molecular epidemiology of HIV and the development of primary drug resistance should be regularly monitored.