Drug resistance mutation analysis of HIV-1 among blood donors in Dalian: 2011—2020

Abstract

Objective To study the distribution and trend of HIV-1 drug resistance mutation in Dalian blood donors between 2011 and 2020. Methods The protease-reverse transcriptase (PR-RT) region was sequenced in Dalian blood donors tested HIV-1 positive between 2011 and 2020. Drug resistance mutation (DRM) rate and level of resistance to selected drugs were analyzed by the Stanford HIV Drug Resistance Database. Results DRM were detected in 17.2% (30/174) of samples, while transmitted drug resistance (TDR) was 5.7% (10/174). Between 2011 and 2020, DRM and TDR rates increased significantly in 2019 and reached their highest levels in 2020 (44.4% and 22.2%, respectively). DRM carriage was associated with people with college degree or above and with local residents (P<0.05). NNRTI DRMs were the most frequently detected (12.6%, 22/174), followed by PIs (5.7%, 10/174), with V179D/E/T and M46I being the main DRMs detected. Only one HIV-1 strain (0.57%, 1/174) carried a NRTI DRM (L74I). The overall rate of predicted high level resistance to antiretroviral drugs was 6.9% (12/174), with the highest proportion of NNRTI resistance (83.3%, 10/12). Two samples were classified as highly resistant to EFV and NVP, accounting for 1.1% (2/174). CRF55_01B strains showed a significantly higher DRM rate than strains of other HIV-1 genotypes (P<0.05). Conclusion Between 2011 and 2020, the rate of HIV-1 DRMs in blood donors in Dalian showed a significant upward trend, particularly in 2019—2020, with NNRTI resistance being the most common. The combination of DRMs detection before and after implementation of ART under the latest national ART treatment plan would improve the effectiveness of HIV-1 prevention and control locally.

Keywords

• hiv-1
• drug resistance mutation
• blood donor