The genotype distribution, infection stage and drug resistance mutation profile of human immunodeficiency virus-1 among the infected blood donors from five Chinese blood centers, 2014–2017

Shan Liang,Ling Shi,Zhiyang Liu,Lili Zhu,Jingxing Wang,Peibin Zeng,Cunxu Liu,Shaoli Wang,Jianhua Wan,Yu Liu,Mei Huang,Paul Ness,Miao He,Wei Mao,Hua Shan,Jing Liu,Chiyu Zhang

doi:10.1371/journal.pone.0243650

Abstract

Human immunodeficiency virus-1 (HIV-1) exhibits high diversity and complexity in China, challenging the disease surveillance and antiretroviral therapy. Between July 1, 2014 and January 30, 2017, we investigated the profiles of HIV-1 infection stages, genotype distribution and drug resistance mutations (DRMs) using plasma samples from HIV Western blot (WB) confirmed blood donors from five Chinese blood centers (Chongqing, Guangxi, Luoyang, Mianyang, and Urumqi). HIV pol regions consisted of whole protease and partial reverse transcriptase were genotyped and analyzed for DRMs. Lag-Avidity testing was performed to identify the infection stages. Of the 356 HIV-1 WB positive samples tested by Lag-avidity assay, 19.1% (68/356) were recent infections. Genotyping on 356 amplified sequences presented the subtype distributions as following: CRF07_BC (65.7%), CRF08_BC (7.3%), CRF01_AE (19.1%), B (4.2%), CRF55_01B (3.1%), CRF59_01B (0.3%) and CRF68_01B (0.3%). No significant difference in genotype distribution was observed between recent and long-term infections. 48 DRMs were identified from 43 samples, indicating a drug resistance prevalence of 12.1% (43/356), which include seven protease inhibitors (PIs) accessory DRMs (Q58E, L23I and I84M), two PIs major DRMs (M46I, M46L), seven nucleoside RT inhibitors DRMs (D67N, K70Q, K219R and M184L), and 32 non-nucleoside RT inhibitors DRMs (K103N, V179E, K238N, V179D, E138G, G190E, A98G, Y188D and E138A). In addition, we had also identified CRFs from the 01B subtype including CRF55_01B (3.1%), CRF59_01B (0.3%) and CRF68_01B (0.3%). As an important part of the continuous monitoring of HIV-1 circulating strains among blood donors, our findings were expected to contribute to the comprehensive AIDS control and development of proper diagnostics for HIV-1 in China.

Highlights

The spread of HIV infection continues to pose a significant public health threat in China as well as globally [1,2]
The main subtypes of Urumqi and Mianyang are consistent with the previous research of REDS-III: CRF07_BC and CRF01_AE
The main subtype of the western region (Chongqing, Urumqi, Mianyang) is CRF07_BC, which is consistent with the previous part

Summary

Introduction

The spread of HIV infection continues to pose a significant public health threat in China as well as globally [1,2]. Studies have shown that the HIV-1 epidemic has spread from high-risk groups to the general population including Chinese blood donors [4]. The predominant genotypes of HIV-1 in the general population in China include circulating recombinant form (CRF) 07_BC, CRF08_BC, CRF01_AE and subtype B [5,6,7]. The risk of transfusion transfusion-transmitted HIV infection in China has been significantly reduced in the past decades [8], the incidence and prevalence of HIV among Chinese blood donors are still persistent [9]. Previous study during 2012 to 2014 from the NHLBL Recipient Epidemiology and Donor Evaluation Study-III (REDS-III) program reported the genotype distribution of HIV-1 infected donors from five blood centers (Chongqing, Guangxi, Luoyang, Mianyang, and Urumqi): CRF07_BC (65.7%), CRF08_BC (7.3%), CRF01_AE (19.1%), B (4.2%), and 01B (3.7%) [7]

Methods

Results

Conclusion