Study On HIV-1 Molecular Epidemiology And Drug Resistance Gene Mutations In China's Unpaid Blood Donor Population

Molecular epidemiologic investigation for human immunodeficiency virus?HIV?and surveillance of drug resistance-associated mutations?DRMs?in viruses among treatment-naive blood donors are critical for viral evolution monitoring and blood safety.This study firstly investigated HIV molecular epidemiology and DRMs among large-scale volunteer blood donors in many areas in China.From 2016 to 2018,199 plasma samples were collected from 26 blood centers?Covering 17 provinces or municipalities?and confirmed as HIV viral load reactive in National Centers for Clinical Laboratories?NCCL?,of which 179 were sequenced and subtyped in the gag,protease?PR?-reverse transcriptase?RT?,integrase?IN?and/or envelope?env?regions.The dominant subtype was CRF07_BC?62/179,34.6%?followed by CRF01_AE?58/179,32.4%?.Many unique recombinant forms?URFs??39/179,21.8%?and other rare CRFs?CRF02_AG,CRF55₀1B,CRF59₀1B,CRF65_cpx,CRF67₀1B,CRF79₀107,CRF85_BC?were also observed in the study.Notably,CRF02_AG and CRF06_cpx strains which were commonly found in Africa were firstly identified in Chinese blood donors,indicating the increasing diversity of HIV-1 in China.DRMs were also common with 29 of 179?16.2%?specimens carrying DRMs,including the PR N88S and RT K103N mutations,which have been implicated in elevated resistance to antiretroviral drugs.In particular,E157Q is the only IN inhibitor DRM observed in the study and has not been reported in the Chinese blood donor population,The viral diversity and DRMs observed in this study highlight the necessity of timely genotypic drug resistance monitoring and molecular epidemiological surveillance of HIV-1 among blood donors.