HIV-1 genetic characteristics and transmitted drug resistance among men who have sex with men in Kunming, China

Abstract

Background: Yunnan has been severely affected by HIV/AIDS in China. Recently, the reported prevalence of HIV-1 among men who have sex with men (MSM) in Yunnan was high in China. To monitor dynamic HIV-1 epidemic among Yunnan MSM, HIV-1 genetic characteristics and transmitted drug resistance (TDR) were investigated. Methods: Blood samples from 131 newly HIV-1 diagnosed MSM were continuously collected at fixed sites from January 2010 to December 2012 in Kunming City, Yunnan Province. Partial gag, pol and env genes were sequenced. Phylogenetic, evolutionary and genotypic drug resistance analyses were performed. Results: Multiple genotypes were identified among MSM in Kunming, including CRF01-AE (64.9%), CRF07-BC (25.2%), unique recombinant forms (URFs, 5.3%), subtype B (3.1%) and CRF08-BC (1.5%). CRF01-AE and CRF07-BC were the predominant strains. The mean of genetic distance within CRF01-AE were larger than that within CRF07-BC. The estimated introducing time of CRF01-AE in Yunnan MSM (1996.9) is earlier than that of CRF07-BC (2002.8). In this study, subtype B was first identified in Yunnan MSM. CRF08-BC seems to be the distinctive strain in Yunnan MSM, which was seldom found among MSM outside Yunnan. The proportion of URFs increased, which further contributed to genetic diversity among MSM. Strikingly, genetic relatedness was found among these strains with MSM isolates from multiple provinces, which suggested that a nationwide transmission network may exist. TDR-associated mutations were identified in 4.6% individuals. The multivariate analysis revealed that non-native MSM and divorced/widowed MSM were independently associated with a higher TDR rate. Conclusion: This work revealed diverse HIV-1 genetics, national transmission networks and a baseline level of TDR in MSM. These findings enhance our understanding of the distribution and evolution of HIV-1 in MSM, and are valuable for developing HIV prevention strategies for MSM. © 2014 Chen et al.