Transmitted drug resistance and transmission clusters among ART-naïve HIV-1-infected individuals from 2019 to 2021 in Nanjing, China

Background Transmitted drug resistance (TDR) is an increasingly prevalent problem worldwide, which will significantly compromise the effectiveness of HIV treatments. However, in Nanjing, China, there still a dearth research on prevalence and transmission TDR among ART-naïve HIV-1-infected individuals. This study aimed to understand Nanjing. Methods A total 1,393 participants who were newly diagnosed with HIV-1 had not received ART between January 2019 December 2021 enrolled this study. pol gene sequence was obtained by viral RNA extraction nested PCR amplification. Genotypes, cluster analyses conducted using phylogenetic tree, Stanford database algorithm HIV-TRACE, respectively. Univariate multivariate logistic regression performed identify factors associated TDR. Results 1,161 sequences successfully sequenced, CRF07_BC (40.6%), CRF01_AE (38.4%) CRF105_0107 (6.3%) main genotypes. The overall 7.8%, 2.0% PIs, 1.0% NRTIs, 4.8% NNRTIs. No showed double-class resistance. Multivariate analysis revealed that compared CRF01_AE, subtype B (OR = 2.869, 95%CI: 1.093–7.420) female 2.359, 1.182–4.707) risk for Q58E most detected protease inhibitor (PI) -associated mutation, V179E frequently non-nucleoside reverse transcriptase (NNRTI) mutation. 613 (52.8%) segregated into 137 clusters, ranging from 2 74 sequences. Among 44 individuals (48.4%) within 21 K103N/KN frequent TDR-associated mutation (31.8%), followed Q58E/QE (20.5%) G190A (15.9%). Individuals same mutations usually cross-linked clusters. Moreover, we identified 9 clusters relationship drug-resistant individuals, 4 cases increased during period. Conclusion Nanjing at moderate level past 3 years. nearly half included some have transmitted Therefore, drug-resistance prevention, monitoring response efforts should be sustained expanded reduce