Characterization of the Near Full-Length Genome of a Novel HIV-1 CRF01_AE/CRF07_BC Recombinant in an Injection Drug User from Southern Taiwan

HIV-1 molecular epidemiology and drug resistance-associated mutations among treatment-naïve blood donors in China

Surveillance of human immunodeficiency virus (HIV) molecular diversity and drug resistance-associated mutations (DRMs) among treatment-naïve blood donors is critical for monitoring viral evolution and blood safety. From 2016-2017, 199 plasma samples were collected from 24 blood centers and confirmed as HIV viral load positive or serologically reactive in National Centers for Clinical Laboratories (NCCL), of which 179 were sequenced and subtyped in the gag, protease (PR)-reverse transcriptase (RT), integrase (IN) and/or envelope (env) regions. DRMs in PR-RT and IN regions were analyzed in Stanford HIVdb Program. The majority of subtypes were circulating recombinant form (CRF) 07_BC (34.6%) and CRF01_AE (32.4%); many unique recombinant forms (URFs) (39, 21.8%) and other rare CRFs were observed in the study. Notably, CRF02_AG and CRF06_cpx strains typically found in Africa were firstly identified amongst Chinese blood donors. DRMs were common, with 28 of 179 (15.6%) specimens carrying DRMs, including the PR N88S and RT K103N mutations, which have been implicated in elevated resistance to antiretroviral drugs. Furthermore, 4 HIV-1 isolates (2.4%, 4/168) had surveillance drug-resistance mutation (SDRM), including 3 nonnucleosidereverse transcriptase inhibitors (NNRTI) SDRMs (1 K101E, 2 K103N) and 1 protease inhibitor (PI) SDRM (M46I). The HIV viral diversity among blood donors observed in this study suggest that ongoing HIV-1 recombination is becoming progressively complex in China, and lots of DRMs found in the study exacerbate the primary drug resistance landscape, which highlight the necessity of timely genotypic drug resistance monitoring and molecular surveillance of HIV-1 among blood donors.

Genomic Characterization of a New HIV-1 CRF01_AE/CRF07_BC Recombinant Virus Form in Guizhou in Southwest China

A novel HIV-1 second-generation recombinant form (CRF01_AE/CRF07_BC) was isolated from an HIV-positive subject among men who have sex with men (MSM) in Guizhou province in Southwest China. Recombinant analyses of the near full-length genome suggested that the strain was composed of CRF01_AE and CRF07_BC with one region of CRF07-BC inserted into a CRF01-AE backbone. Further analysis indicated that the CRF01_AE regions of the recombinant were highly clustered together with a subcluster 4 lineage of CRF01_AE, which is exclusively circulating among MSM in China. The CRF07_BC region of the recombinant was clustered with the CRF07_BC cluster, which was identified among MSM. The emergence of the novel HIV-1 recombinant may be a harbinger of more novel intersubtypes recombinants occurring in Guizhou province in Southwest China, and was of great important in understanding the dynamics and complexity of the HIV-1 epidemic in this region.

Near Full-Length Genome Identification of a Novel HIV-1 Recombinant Form (CRF01_AE/CRF07_BC) in Zhejiang, China

CRF01_AE and CRF07_BC are the two major circulating recombinant forms (CRFs) in China. Furthermore, many kinds of unique recombinant forms (URFs) between CRF01_AE and CRF07_BC were recently identified in China. Here we detected a novel recombinant of CRF07_BC/CRF01_AE, whose genome structure is distinctly different from other URFs reported before. The phylogenetic analysis of the near full-length sequence of 15zj032 reveals that three regions of CRF01_AE insert into the CRF07_BC backbone. Recently, the continued emergence of novel URFs implies that super infections of different subtypes of HIV-1 are common in China and should be given enough importance.