The Study Of Correlation Of Transmission Between HIV-1/HCV And HIV-1 Drug Resistance Among HIV/HCV Co-infected Drug Users In Kaiyuan Prefecture And Yingjiang County Of Yunnan Province

Yunnan Province is located in southwest China,which borders with Laos,Vietnam and Thailand.Along “Golden Triangle Region”,Yunnan has become a important channel to import heroin into China.So special geographical environment,viruses such as HIV,HCV hit Yunnan seriously.As both of HIV and HCV can transmit through blood?mother to child and sexual,HIV and HCV co-infection are very widespread.Previous studies showed that the prevalence of HIV,HCV among drug users of Yunnan Province were high,and co-infection of HIV,HCV were also common.The present study investigated a molecular epidemiology of HIV-1 and HCV,the correlation of transmission between two viruses and HIV-1 drug resistance among HIV/HCV co-infected drug users in Kaiyuan Prefecture and Yingjiang County of Yunnan Province,and to provide theoretical preference for controlling two virus in this area.Firstly,our study investigated the subtypes of HIV,HCV and the correlation of transmission between two viruses among HIV/HCV co-infected drug users in Kaiyuan Prefecture and Yingjiang County of Yunnan Province.We performed phylogenetic analysis and phylogeographical analysis among 305 HIV/HCV co-infected drug users of Yunnan Province(178 cases from Kaiyuan Prefecture and 127 cases from Yingjiang County).The HIV-1 subtypes/recombinants were BC recombinants,subtype B,subtype C,CRF01_AE,CRF01_AE/B,CRF01_AE/C,CRF01_AE/B/C,CRF07_BC and CRF08_BC.High prevalence of BC recombinants was found among this group of this area.Similarly,diverse forms of HCV subtypes including genotype 1(1a,1b),genotype 3(3a,3b)and genotype 6(6a,6n,6u,6v)were found.HCV subtype 3b was the most predominant among HIV/HCV co-infected drug users in Kaiyuan Prefecture and Yingjiang County of Yunnan Province.Furthermore,results of phylogeographic analysis showed that the transmission routes of HIV,HCV among HIV/HCV co-infected drug users in Kaiyuan Prefecture and Yingjiang County of Yunnan Province were same.No matter HIV or HCV,they spread from Yingjiang County to Kaiyuan Prefecture.We further downloaded HIV and HCV sequences of Dehong and Honghe Prefecture,Yunnan Province from Database to perform phylogeographic analysis.Results coincided with our conclusion.Besides,our study investigated HIV-1 drug resistance characteristic among HIV/HCV co-infected drug users in Kaiyuan Prefecture and Yingjiang County of Yunnan Province.From 305 HIV/HCV co-infected drug users,202 HIV-1 pol fragments were successfully amplified and analyzed.Among them,32 cases were under HIV-1 antiretroviral treatment,81 cases were not,and the antiretroviral information of the rest 89 cases were unknown.The rate of drug resistance in the treated group(40.6%,n=13)was significantly higher than that in the untreated group(8.6%,n=7)(?2=16.108,P<0.001).Most treated cases exhibited high-level resistance to Nevirapine,Efavirenz,Lamivudine,Stavudine and Emtricitabine;while,only a few untreated cases conferred high resistance to Saquinavir?Etravirine and Rilpivirine.The rate of HIV-1 drug resistance among HIV/HCV co-infected drug users in Kaiyuan Prefecture and Yingjiang County of Yunnan Province was high,and the current first-line and second-line treatment were still effective.However,those who failed in the first-line treatment were strongly advised to be included in the second-line treatment as soon as possible.