Abstract
BackgroundThe drug resistance and the virologic failure of antiretroviral therapy (ART) are quite severe in Liangshan. A better understanding of the virologic failure of ART and the HIV-1 transmission network dynamics is essential for the surveillance and prevention of HIV. Here, we analyzed the HIV-1 CRF07_BC strain genetic transmission networks and their associated factors among people living with HIV-1 (PLWH) who had virologic failure of ART by using close genetic links.MethodsThe drug-resistant mutations were determined using the Stanford University HIV Drug Resistance Database. HIV-1 pol genes sequences were used for phylogenetic and genotypic drug resistance analysis. The genetic transmission networks were performed by comparing sequences, constructing the phylogenetic tree, calculating the pairwise distance, and visualizing the network.ResultsA total of 1050 PLWH with CRF07_BC pol sequences were finally identified and included in the genetic transmission network analysis from 2016 to 2017. Of the 1050 CRF07_BC pol sequences, 346 (32.95%) fell into clusters at a genetic distance of 0.006, resulting in 137 clusters ranging in size from 2 to 40 individuals. Subjects who were widowed or divorced were less likely to form a genetic transmission network (adjusted OR: 0.50), while subjects who had shared a needle ≥ five times were more likely to form a network (adjusted OR: 1.88).ConclusionsThe genetic transmission networks revealed the complex transmission pattern, highlighting the urgent need for transmission monitoring of virologic failure of ART and selection of more effective therapeutic regimens to promote viral suppression.
Highlights
The drug resistance and the virologic failure of antiretroviral therapy (ART) are quite severe in Liangshan
We investigated the Human Immunodeficiency Virus (HIV)-1 CRF07_BC strain transmission patterns among people living with HIV-1 (PLWH) who had virologic failure by using close genetic links and explored the factors associated with genetic transmission networks in Liangshan Prefecture
Among PLWH with virologic failure of ART, the drug-resistant rate was as high as 32.10% (507/1576)
Summary
The drug resistance and the virologic failure of antiretroviral therapy (ART) are quite severe in Liangshan. We analyzed the HIV-1 CRF07_BC strain genetic transmission networks and their associated factors among people living with HIV-1 (PLWH) who had virologic failure of ART by using close genetic links. According to previous sampling survey reports, the effective rate of antiretroviral therapy (ART) among PLWHin Liangshan Prefecture was only 55.9%, and the drug resistance rate of newly reported untreated patients was as high as over 5% [3]. The high virologic failure rate and drug resistance rate of ART in Liangshan Prefecture were mainly due to the poor adherence to ART, the high mobility, and the high lost-to-follow-up rate of PLWH [4, 5]. Effective intervention should be formatted to reduce drug resistance in this area
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