The Epidemic Of Acquired And Transmitted HIV Drug Resistance Among Men Who Have Sex With Men In Jiangsu Province, China

Objective:1. To explore the incidence and correlates of acquired HIV drug resistance among men who have sex with men (MSM) on highly active antiretroviral therapy (HAART).2.To survey the prevalence of transmitted HIV drug resistance among men who have sex with men younger than 25 years old.Methods:1.We conducted a prospective cohort study in Jiangsu province to estimate the incidence of acquired HIV drug resistance (HDR). Cox regression model was used to explore the correlations of HIV drug resistance.2.We used the method of Truncated sequential sampling to sample MSM. And we sequenced the HIV pol gene to estimate the mutations associated with the drug resistance. We used the Stanford HIV Drug Resistance Database to analyze the drug resistance. And HIV BLAST was used to analyze the subtypes of HIV.Results:1.During the follow-up period,23 MSM acquired drug resistance, the incidence was 2.72 per 100 person-years. The independent risk factors of HDR were the CD+T cell count(less than 200 copies/μl) before ART(HR:3.210; 95%CI:1.33～7.733), and the use of nevirapine (NVP) on initial regimen(HR:2.852; 95%CI:1.194～6.817).2. We found no mutations associated with HIV drug resistance among new infected MSM. The subtypes of them are CRF01_AE(29/47), CRF07_BC(12/47), subtype C(3/47), subtype B(1/47) and URFs(3/47).Conclusion:1.The incidence of acquired HDR among MSM on ART was low. Early treatment of MSM infected with HTV-1 was recommended according to our study. It’s better to use EFV rather than NVP when initiate ART.2. The prevalence of transmitted HIV drug resistance was low. There’s no need for HIV drug resistance test before ART. Compared with the research of 5 years ago, the HIV subtypes have changed, and further study is needed.