Objective To investigate the gene mutations of human immunodeficiency virus (HIV)-1 drug resistance among anti-retrovirus (ARV) treated-naive men who have sex with men (MSM) in Shanghai to provide evidence-based data for optimized treatment. Methods All 669 treatment-naive cases of HIV-1 infection identified among MSM in 2013 were recruited and their plasma was collected. RNA was extracted and amplified by nest reverse transcription-polymerase chain reaction, and DNA was sequenced and then phylogenetically analyzed. Finally, subtypes were identified and drug resistance was analyzed in comparison with International HIV Drug Resistance Database. Results The pol gene fragments of 645 cases were obtained. Primary drug-resistance rate was 2.48% (16/645), including mutations conferring resistance to protease inhibitor (PI) (0.31%, 2/645), nucleoside reverse transcriptase inhibitors (NRTI) (0.16%, 1/645), non-nucleoside reverse transcriptase inhibitors (NNRTI) (1.70%, 11/645) and both NRTI and NNRTI (0.31%, 2/645), respectively. Mutations conferring resistance to CRF01_AE were 12 cases (2.99%), while mutations conferring resistance to CRF07_BC and CRF_01B were 0.61% (1/163) and 4.65% (2/43) including 1 case of CRF52_01B and unidentified CRF_01B, respectively. Resistance to NNRTI in B subtype were 2.70% (1/37). Conclusion The prevalence of HIV-1 drug resistance-associated mutations among MSM in Shanghai, 2013 is still low, but resistance to NNRTI is relatively high. CRF01_AE is the major subtype of drug resistance. It is necessary to strengthen the HIV drug resistance surveillance in MSM group in Shanghai. Key words: Human immunodeficiency virus-1; Homosexuality, male; Subtype/recombinant; Drug resistance
Read full abstract