Study On Secondary Resistance To HIV - 1 Transmission Resistance Analysis And Deep Sequencing In Some Areas Of China

[Objective]:To elucidate the epidemiology of HIV/AIDS in China by analyzing the baseline data of all the patients from the cART cohort of China in the last20years, mainly focused on HIV-1subtypes and drug resistance. To detect and quantify the HIV-1drug resistance loci in the virological failure patients using a highly sensitive pyrosequencing method.[Methods]:The treatment-naive patients’ baseline data was collected by clinical and laboratory methods, including their age, sex, region, routes of infection, etc. Subtype and drug resistance were detected through a general Sanger method. The transmitted drug resistance and subtype were analysed according to their time of infection, region and routes of infection.39patients were chosen from the cohort, the general Sanger method showed negative results in their baseline data, yet they undergo a viral load rebound in their treatment.3drug resistance loci, namely67,70,184, were redetected by pyrosequencing method on both the baseline and the time of viral load rebound.[Results]:The routes of infection and the most frequent HIV subtype in China undergoes a huge changing in the past20years. The blood transmission decreased while the homosexual transmission rise (p<0.01). The most frequent subtype is AE type, and then B type and BC type. AE type increased year by year and took place of B type. Different regions showed different subtype distribution. Sexual transmission people were mainly AE type, while B type dominated in the blood transmission people.With57in861patients were detected drug resistance, the transmitted drug resistance rate was6.6%.84loci were detected, there were26NRTIs (31%),36NNRTIs (43%),22PI (26%). In the26NRTIs,7of them were non-TAMs (27%),14were TAMs (54%),5were MDR (19%).NRTIs/PI loci were mainly low level resistance, while NNRTIs loci had a higher percentage of high-level.3drug resistance loci, namely67,70,184, were redetected by pyrosequencing method on both the baseline and the time of viral load rebound. At the baseline,23of39(59.0%) patients were detected drug resistance, there were15(38.5%) D67,7(17.9%) K70, and19(48.7%) M184. At the time of rebound, most of the patients had M184mutation, and content increase of the mutation were observed in8patients.[Conclusions]:The epidemiology of HIV in China undergoes a huge changing in the past20years. In place of blood transmission, sexual transmission became the most popular route of infection, and the number is still increasing. For the linkage between sexual transmission and AE type, AE type has become the most frequent subtype in China.The transmitted drug resistance rate of the cohort is6.6%, and the rate is increasing year by year.Pyrosequencing can detect minor drug resistant strain which the general Sanger method failed to detect; the prevalence of minor drug resistant strain in viral rebounce patients indicated a need for pyrosequencing in the early stage of treatment. Content increase of mutation observed in those patients indicated the linkage between minor drug resistant strain and viral rebounce.