Abstract
BackgroundHuman immunodeficiency virus type 1 (HIV-1) genetic diversity and pre-treatment drug resistance (PDR) are major barriers to successful antiretroviral therapy (ART). In China, sexual intercourse is the most frequent route of HIV-1 transmission. However, few studies have analyzed PDR and transmission networks in detail among individuals in China with acute HIV-1 infection and their sexual contacts.MethodsA cross-sectional study was conducted in Baoding City, Hebei Province, China from 2019–2020. CD4 T cell counts and viral loads were assessed and a HIV-1 genotypic PDR assay was developed in-house. Transmission networks were visualized using Cytoscape with a threshold genetic distance of 0.015 among HIV-1 subtypes.ResultsFrom 139 newly diagnosed and drug-naïve individuals with HIV-1, 132 pol gene sequences were obtained and revealed eight HIV-1 subtypes. Circulating recombinant form (CRF)01_AE was the most frequent subtype (53.0%, 70/132) followed by CRF07_BC (26.5%, 35/132), B (13.6%, 18/132), unique recombinant forms (2.3%, 3/132), CRF55_01B (1.5%, 2/132), CRF103_01B (1.5%, 2/132), CRF65_cpx (0.8%, 1/132), and C (0.8%, 1/132). A total of 47 pol gene sequences were used to generate 10 molecular transmission networks. The overall prevalence of PDR was 7.6% and that of PDR to non-nucleotide reverse transcriptase inhibitors was 6.1%. Of three transmission networks for PDR, two were closely associated with Beijing and Tianjin, while another was restricted to sequences determined in this study.ConclusionsThese results demonstrate that during acute HIV-1 infection, PDR is transmitted in dynamic networks. This suggests that early detection, diagnosis, surveillance, and treatment are critical to effectively control HIV-1 spread.
Highlights
The Joint United Nations Programme on human immunodeficiency virus (HIV)/acquired immune deficient syndrome (AIDS) (UNAIDS) report showed that 37.7 million people were living with HIV worldwide in 2020 [1]
These results demonstrate that during acute Human immunodeficiency virus type 1 (HIV-1) infection, pre-treatment drug resistance (PDR) is transmitted in dynamic networks
This suggests that early detection, diagnosis, surveillance, and treatment are critical to effectively control HIV-1 spread
Summary
The Joint United Nations Programme on human immunodeficiency virus (HIV)/acquired immune deficient syndrome (AIDS) (UNAIDS) report showed that 37.7 million people were living with HIV worldwide in 2020 [1]. Over the past four decades, HIV control efforts have been very successful. The success of HIV control has been mostly attributed to the development of antiretroviral therapy (ART) [2,3,4,5]. Human immunodeficiency virus type 1 (HIV-1) genetic diversity and pre-treatment drug resistance (PDR) are major barriers to successful antiretroviral therapy (ART). In China, sexual intercourse is the most frequent route of HIV-1 transmission. Few studies have analyzed PDR and transmission networks in detail among individuals in China with acute HIV-1 infection and their sexual contacts
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