Abstract
Surveillance on the HIV molecular variability, risk of drug resistance transmission and evolution of novel viral variants among blood donors remains an understudied aspect of hemovigilance. This nationwide study analyses patterns of HIV diversity and transmitted resistance mutations. Study included 185 samples from the first time and repeat blood donors with HIV infection identified by molecular assay. HIV protease, reverse transcriptase and integrase were sequenced using population methods. Drug resistance mutation (DRM) patterns were analyzed based on the Stanford Interpretation Algorithm and standardized lists of transmitted mutations. Phylogeny was used to investigate subtyping, clustering and recombination patterns. HIV-1 subtype B (89.2%) followed by subtype A6 (7.6%) were predominant, while in three (1.6%) cases, novel recombinant B/A6 variants were identified. Non-B variants were more common among repeat donors (14.5%) compared to the first time ones (1.8%), p = 0.011, with higher frequency (9.9%) of A6 variant in the repeat donor group, p = 0.04. Major NRTI DRMs were observed in 3.8%, NNRTI and PI in 0.6% and INSTI 1.1% of cases. Additionally, E157Q polymorphism was observed in 9.8% and L74I in 11.5% of integrase sequences. Transmission of drug resistance among blood donors remains infrequent. Subtype patters increase in complexity with emergence of novel intersubtype A6B recombinants.
Highlights
Surveillance on the HIV molecular variability, risk of drug resistance transmission and evolution of novel viral variants among blood donors remains an understudied aspect of hemovigilance
Molecular characteristics of the HIV strains observed among blood donors may reflect circulation patterns in the untested general population, generally unaware of the transmission risk, which in turn is of the primary importance to the blood s afety[8]
Mathematical models estimate the risk of infectious transfusions at 0.16 to 0.49 per million, depending on screening format and type of blood component[19]. In this considerably sized nationwide study, HIV diversity, patterns of transmitted drug resistance and clustering among Polish blood donors were analysed. This is the first study informing on the molecular variability of HIV in this group, identifying risk of Drug resistance mutation (DRM) transmission and evolution of novel viral variants, which is of the utmost importance for the blood services
Summary
Surveillance on the HIV molecular variability, risk of drug resistance transmission and evolution of novel viral variants among blood donors remains an understudied aspect of hemovigilance This nationwide study analyses patterns of HIV diversity and transmitted resistance mutations. Mathematical models estimate the risk of infectious transfusions at 0.16 to 0.49 per million, depending on screening format (sensitivity) and type of blood component (plasma volume)[19] In this considerably sized nationwide study, HIV diversity, patterns of transmitted drug resistance and clustering among Polish blood donors were analysed. This is the first study informing on the molecular variability of HIV in this group, identifying risk of DRM transmission and evolution of novel viral variants, which is of the utmost importance for the blood services
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