Changing Proportions of HIV-1 Subtypes and Transmitted Drug Resistance Among Newly Diagnosed HIV/AIDS Individuals—China,2015 and 2018

Introduction:With the expansion of human immunodeficiency virus(HIV)antiretroviral therapy(ART),HIV drug resistance is becoming more and more serious.This study describes the changing prevalence of HIV-1 subtypes and transmitted drug resistance(TDR)among newly diagnosed individuals in China,2015 and 2018.Methods:A total of 8,980 individuals in 2015 and 2018 from 31 provincial-level administrative divisions(PLADs)were enrolled in this study.Viral RNAs were amplified and sequenced using an in-house polymerase chain reaction(PCR)protocol.The Stanford HIV Drug Resistance Database(HIVdb)was used to predict susceptibility to 12 antiretroviral drugs.Results:The prevalence of TDR was not significantly increased over time.The prevalence of TDR was 3.8%and 4.4%in 2015 and 2018,respectively(P=0.13).The prevalence of CRF55_01B increased from 2.3%in 2015 to 3.9%in 2018(P<0.001).The drug resistance prevalence of nonnucleoside reverse transcriptase inhibitors(NNRTI)increased from 2.4%in 2015 to 3.3%in 2018(P<0.01).The prevalence of E138(P<0.001),H221(P=0.03),and V179(P<0.001)mutations increased from 0.30%,0.09%,and 0.70%in 2015 to 1.10%,0.30%,and 1.70%in 2018,respectively.Conclusions:HIV drug resistance affects the effect of antiretroviral treatment,so the monitoring of HIV TDR should be strengthened to control the transmission of HIV drug resistance.