# Characterization of transmitted drug resistance among recently infected HIV-1 men who have sex with men in Hebei Province, China

## TL;DR

This study examines drug resistance in recently infected HIV-1 men who have sex with men in Hebei, China, finding moderate resistance levels and highlighting the need for ongoing monitoring.

## Contribution

The study provides the first comprehensive TDR profile for recently infected MSM in Hebei, China.

## Key findings

- CRF07_BC and CRF01_AE were the most common HIV-1 subtypes among participants.
- The overall transmitted drug resistance prevalence was 7.51%, with INSTIs showing the highest resistance rate.
- One participant had resistance to three drug classes: NRTIs, NNRTIs, and INSTIs.

## Abstract

Despite transmitted drug resistance (TDR) surveillance is the critical role in HIV-1 prevention strategies, epidemiological data remain scarce for newly infected men who have sex with men (MSM) in Hebei Province, China. To address this data gap, we conducted a cross-sectional study involving 173 MSM recently infected with HIV-1. Plasma samples were subjected to HIV-1 RNA extraction, followed by amplification and sequencing of the pol gene region (PR-RT: 1.3 kb; IN: 0.8 kb). In this study, 173 sequences were successfully sequenced, and the sequencing success rate was 92.5% (173/187). Subtyping analysis revealed a predominance of CRF07_BC (36.4%, 63/173) and CRF01_AE (32.3%, 56/173), with a notable proportion of unique recombinant form (URF, 20.2%, 35/173). The overall TDR prevalence was 7.51% (13/173), categorized by drug class as follows: protease inhibitors (PIs, 2.31%, 4/173), nucleoside reverse transcriptase inhibitors (NRTIs, 1.16%, 2/173), non-nucleoside reverse transcriptase inhibitors (NNRTIs, 2.31%, 4/173), and integrase strand transfer inhibitors (INSTIs, 2.89%, 5/173). Notably, one participant exhibited concurrent resistance to NRTIs, NNRTIs, and INSTIs. While these findings suggest moderate TDR control in Hebei’s MSM population, we emphasize the necessity for sustained surveillance to dynamically assess treatment program efficacy, optimize second-line therapy regime, and guide public health interventions. This study provides the first comprehensive TDR profile for recently infected individuals in Hebei, offering critical insights for regional HIV-1 management.