Prevalence of transmitted HIV-1 drug resistance among treatment-naive individuals in China, 2000-2016

Human immunodeficiency virus (HIV) with transmitted drug-resistance (TDR) limits the therapeutic options available for treatment-naive HIV patients. This study aimed to further our understanding of prevalence and transmission characteristics TDR application first-line antiretroviral regimens. A total 6578 HIV-1 protease/reverse-transcriptase sequences from individuals in China between 2000 2016 were obtained Los Alamos Sequence Database analyzed TDR. Transmission networks constructed determine genetic relationships. The spreading routes large clusters identified using a Bayesian phylogeographic framework. mutations detected 274 (4.51%) individuals, 1.40% associated resistance nucleoside reverse transcriptase inhibitors, 1.52% non-nucleoside 1.87% protease inhibitors. most frequent mutation was M46L (58, 0.89%), followed by K103N (36, 0.55%), M46I M184V (26, 0.40%). initially decreased 2010 (OR = 0.83, 95% CI 0.73–0.95) then increased thereafter 1.50, 1.13–1.97). proportion cluster (clustering rate) among isolates lower than that without (40.5% vs. 48.8%, P 0.023) 27.3% 2005–2006 63.6% 2015–2016 (P < 0.001). While reduced relative fitness, higher fitness wild-type strain. low-level during last two decades. However, increasing rate since 2010, persistent circulation drug mutations, expansion self-sustaining reservoirs may compromise efficacy therapy programs.