title: Increase of RT-related transmitted drug resistance in non-CRF01_AE among HIV type 1-infected men who have sex with men in the 7 cities of China.
abstract: OBJECTIVE
  To elucidate new features in the prevalence of HIV-1 transmitted drug resistance (TDR) in men who have sex with men (MSM) in China.
  
  
  METHODS
  A total of 441 HIV-1-positive subjects were recruited from high-risk MSM populations in 7 cities across China between 2012 and 2013. Nucleotide sequences of 1.1-kb pol-RT regions were amplified and sequenced from 367 of the 441 samples. Phylogenetic and genetic drug-resistant analyses were performed.
  
  
  RESULTS
  The overall distribution of HIV-1 genotypes was as the following: CRF01_AE, 52.3%; CRF07_BC, 33.2%; 01/B recombinants, 6.0%; subtype B (United States-European), 3.8%; subtype B', 3.8%; and CRF08_BC, 0.8%. About 91.3% of the sequences clustered together. An overall 4.6% TDR rate was found. Reverse transcriptase (RT)-related TDR reached 2.7%. TDR of 2.2% was detected in protease region. Most of RT-related TDRs were detected in non-CRF01_AE subtypes (90.0%, 9/10), including T215A/S, K101E, K103N, V106M, and E138G. Most of the strains with TDRs (88.2%, 15/17) were presented in the clusters. TDR strains against non-nucleoside reverse transcriptase inhibitors in non-CRF01_AE subtypes also formed some subclusters (70.0%, 7/10). One CRF07_BC subject with K103N in Kunming had a very close genetic distance with one that received highly active antiretroviral therapy locally (bootstrap = 99%). Two CRF55_01B subjects carrying K103N in Changsha and Nanjing also had a very close genetic distance (bootstrap = 100%).
  
  
  CONCLUSIONS
  RT-related TDR of non-CRF01_AE became the main TDR among MSM in China. There is an increasing trend and a potential transmission risk for the RT-related TDR among MSM throughout China. Some TDRs could have already been transmitted among different cities. Intervention efforts should be strengthened among MSM to prevent further transmission of HIV and the proliferation of the strains with TDR.
authors.affiliation: *Key Laboratory of AIDS Immunology of National Health and Family Planning Commission, Department of Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, China; †Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Hangzhou, China; ‡Yunnan Provincial Center for Disease Control and Prevention, Kunming, China; §Henan Provincial Centers for Disease Control and Prevention, Zhengzhou, China; ‖Sexually Transmitted Disease and AIDS Department, Shandong Provincial Center for Disease Control and Prevention, Jinan, China; ¶AIDS/STIs Prevention and Control Department, Hunan Provincial Center for Disease Control and Prevention, Changsha, China; #Sexually Transmitted Disease and AIDS Prevention and Control Department, Jiangsu Provincial Center for Disease Control and Prevention, Nanjing, China; **Sexually Transmitted Disease and AIDS Department, Shanghai Municipal Center for Disease Control and Prevention, Shanghai, China; and ††Rhode Island Hospital, Providence, RI.
authors.forename: Bin
authors.initials: B
authors.lastname: Zhao
authors.forename: Xiaoxu
authors.initials: X
authors.lastname: Han
authors.forename: Junjie
authors.initials: J
authors.lastname: Xu
authors.forename: Qinghai
authors.initials: Q
authors.lastname: Hu
authors.forename: Zhenxing
authors.initials: Z
authors.lastname: Chu
authors.forename: Jing
authors.initials: J
authors.lastname: Zhang
authors.forename: Lin
authors.initials: L
authors.lastname: Lu
authors.forename: Zhe
authors.initials: Z
authors.lastname: Wang
authors.forename: Jihua
authors.initials: J
authors.lastname: Fu
authors.forename: Xi
authors.initials: X
authors.lastname: Chen
authors.forename: Hongjing
authors.initials: H
authors.lastname: Yan
authors.forename: Minghua
authors.initials: M
authors.lastname: Zhuang
authors.forename: Lin
authors.initials: L
authors.lastname: Wang
authors.forename: Amy
authors.initials: A
authors.lastname: Sun
authors.forename: Christiana Meng
authors.initials: CM
authors.lastname: Zhang
authors.forename: Hong
authors.initials: H
authors.lastname: Shang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D019380:Anti-HIV Agents / Q000494:pharmacology*; D002681:China / Q000453:epidemiology; D002947:Cities / Q000453:epidemiology; D003430:Cross-Sectional Studies; D024882:Drug Resistance, Viral; D005838:Genotype; D015658:HIV Infections / Q000635:transmission* / Q000821:virology; D054303:HIV Reverse Transcriptase / Q000235:genetics; D015497:HIV-1 / Q000145:classification / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification; D018451:Homosexuality, Male; D006801:Humans; D008297:Male; D008875:Middle Aged; D010802:Phylogeny; D018894:Reverse Transcriptase Inhibitors / Q000494:pharmacology*; D017422:Sequence Analysis, DNA; D055815:Young Adult; D054302:pol Gene Products, Human Immunodeficiency Virus / Q000235:genetics
chemical_list: D019380:Anti-HIV Agents; D018894:Reverse Transcriptase Inhibitors; D054302:pol Gene Products, Human Immunodeficiency Virus; C514824:reverse transcriptase, Human immunodeficiency virus 1; D054303:HIV Reverse Transcriptase