title: Genetic diversity of HIV-1 and transmitted drug resistance among newly diagnosed individuals with HIV infection in Hangzhou, China.
abstract: HIV transmitted drug resistance (TDR) can compromise antiretroviral therapy (ART) in resource-limited countries like China where ART has been scaled up and thus leads to an important public health concern. The aim of the study was to elucidate the HIV-1 genetic characteristics and TDR in Hangzhou, China. Two-hundred eleven ART-naive, newly diagnosed individuals were enrolled during January and August 2013. Specimens were classified as recent or chronic infections using the BED capture enzyme immunoassay (BED-CEIA). The pol fragment covering the entire protease and the first 300 codons of the reverse transcriptase gene was amplified by RT-PCR and nested PCR. Genotypic drug resistance (DR) and phylogenetic analysis were performed on the 200 obtained sequences. Multiple genotypes were identified, including CRF01_AE (62.0%), CRF07_BC (31.0%), subtype B (2.0%), CRF08_BC (1.5%), CRF55_01B (1.0%), CRF18_cpx (0.5%), and unique recombinant forms (URFs, 2.0%). All the four URFs were found in men who have sex with men, consisting of a recombination of CRF01_AE with subtype B or CRF07_BC. The prevalence of primary DR in newly diagnosed individuals in Hangzhou was low (4.0%). The proportion of DR mutation to protease inhibitors (PIs), nucleoside reverse transcriptase inhibitors (NRTIs) and non-nucleoside reverse transcriptase inhibitors (NNRTIs) was 1.5%, 1.5%, and 1.0%, respectively. BED-CEIA revealed that 21.8% (45/211) of the specimens were associated with recent infections. The prevalence of TDR in recent infections was moderate (6.5%). High HIV diversity and relatively high prevalence of TDR in new infections has been found in Hangzhou, indicating an increasing challenge for future HIV prevention and treatment.
authors.affiliation: Department of HIV/AIDS & STD control and prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China.
authors.forename: Jiafeng
authors.initials: J
authors.lastname: Zhang
authors.affiliation: Department of HIV/AIDS & STD control and prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China.
authors.forename: Zhihong
authors.initials: Z
authors.lastname: Guo
authors.affiliation: Department of HIV/AIDS & STD control and prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China.
authors.forename: Jiezhe
authors.initials: J
authors.lastname: Yang
authors.affiliation: Department of HIV/AIDS & STD control and prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China.
authors.forename: Xiaohong
authors.initials: X
authors.lastname: Pan
authors.affiliation: Department of HIV/AIDS & STD control and prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China.
authors.forename: Jun
authors.initials: J
authors.lastname: Jiang
authors.affiliation: Department of HIV/AIDS & STD control and prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China.
authors.forename: Xiaobei
authors.initials: X
authors.lastname: Ding
authors.affiliation: Department of HIV/AIDS & STD control and prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China.
authors.forename: Wenjun
authors.initials: W
authors.lastname: Zhang
authors.affiliation: Department of HIV/AIDS & STD control and prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Xia
authors.affiliation: Department of HIV/AIDS & STD control and prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China.
authors.forename: Yun
authors.initials: Y
authors.lastname: Xu
authors.affiliation: Department of HIV/AIDS & STD control and prevention, Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou, China.
authors.forename: Jingjing
authors.initials: J
authors.lastname: Huang
mesh_terms: D000293:Adolescent; D000328:Adult; D000998:Antiviral Agents / Q000627:therapeutic use; D002681:China / Q000453:epidemiology; D024921:Drug Resistance, Multiple, Viral / Q000235:genetics; D005260:Female; D014644:Genetic Variation; D005838:Genotype; D015658:HIV Infections / Q000453:epidemiology / Q000821:virology*; D017320:HIV Protease Inhibitors / Q000494:pharmacology / Q000627:therapeutic use; D015497:HIV-1 / Q000187:drug effects* / Q000235:genetics*; D006801:Humans; D008297:Male; D008969:Molecular Sequence Data; D010802:Phylogeny; D015995:Prevalence; D011480:Protease Inhibitors / Q000627:therapeutic use; D060888:Real-Time Polymerase Chain Reaction; D018894:Reverse Transcriptase Inhibitors / Q000494:pharmacology / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D000998:Antiviral Agents; D017320:HIV Protease Inhibitors; D011480:Protease Inhibitors; D018894:Reverse Transcriptase Inhibitors
keywords: HIV; antiretroviral therapy; virus evolution/diversity