Transmitted drug resistance to Tenofovir/Emtricitabine among persons with newly diagnosed HIV infection in Shenyang city, Northeast China from 2016 to 2018

Zhen Wang,Minghui An,Lu Wang,Lin Wang,Wen Tian,Wei Song,Xin Li,Haibo Ding,Xiaoxu Han,Xue Dong,Bin Zhao

doi:10.1186/s12879-021-06312-3

Abstract

BackgroundTo assess transmitted drug resistance (TDR) to tenofovir (TDF)/emtricitabine (FTC), using as pre-exposure prophylaxis, among newly diagnosed human immunodeficiency virus-1 (HIV-1)-infected residents in Shenyang city, northeast China.MethodsDemographic and epidemiological information of all newly diagnosed HIV-1 infected residents in Shenyang city from 2016 to 2018 were anonymously collected from the local HIV epidemic database. HIV-1 pol sequences were amplified from RNA in cryopreserved plasma samples and sequenced directly. Viral subtypes were inferred with phylogenetic analysis and drug resistance mutations (DRMs) were determined according to the Stanford HIVdb algorithm. Recent HIV infection was determined with HIV Limiting Antigen avidity electro immunoassay.ResultsA total of 2176 sequences (92.4%, 2176/2354) were obtained; 70.9% (1536/2167) were CRF01_AE, followed by CRF07_BC (18.0%, 391/2167), subtype B (4.7%, 102/2167), other subtypes (2.6%, 56/2167), and unique recombinant forms (3.8%, 82/2167). The prevalence of TDR was 4.9% (107/2167), among which, only 0.6% (13/2167) was resistance to TDF/FTC. Most of these subjects had CRF01_AE strains (76.9%, 10/13), were unmarried (76.9%, 10/13), infected through homosexual contact (92.3%, 12/13), and over 30 years old (median age: 33). The TDF/FTC DRMs included K65R (8/13), M184I/V (5/13), and Y115F (2/13). Recent HIV infection accounted for only 23.1% (3/13). Most cases were sporadic in the phylogenetic tree, except two CRF01_AE sequences with K65R (Bootstrap value: 99%).ConclusionsThe prevalence of TDR to TDF/FTC is low among newly diagnosed HIV-infected cases in Shenyang, suggesting that TDR may have little impact on the protective effect of the ongoing CROPrEP project in Shenyang city.

Highlights

To assess transmitted drug resistance (TDR) to tenofovir (TDF)/emtricitabine (FTC), using as preexposure prophylaxis, among newly diagnosed human immunodeficiency virus-1 (HIV-1)-infected residents in Shenyang city, northeast China
The prevalence of TDR to TDF/FTC is low among newly diagnosed HIV-infected cases in Shenyang, suggesting that TDR may have little impact on the protective effect of the ongoing CROPrEP project in Shenyang city
In 2012, Truvada was firstly approved as a Pre-exposure prophylaxis (PrEP) drug by the US Food and Drug Administration (FDA)

Summary

Introduction

To assess transmitted drug resistance (TDR) to tenofovir (TDF)/emtricitabine (FTC), using as preexposure prophylaxis, among newly diagnosed human immunodeficiency virus-1 (HIV-1)-infected residents in Shenyang city, northeast China. Pre-exposure prophylaxis (PrEP) with antiviral drugs in high risk populations is considered an effective way to prevent human immunodeficiency virus (HIV) infection. In 2012, the World Health Organization (WHO) released guidelines to help uninfected people at risk of HIV infection use PrEP [1]. In 2012, Truvada was firstly approved as a PrEP drug by the US Food and Drug Administration (FDA). This compound preparation consists of two nucleoside reverse transcription inhibitors (NRTIs): tenofovir (TDF) and emtricitabine (FTC). No PrEP drug has been approved in China yet

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