JMIR Publications

ABSTRACT

Background:

In China, men who have sex with men (MSM) have become one of the high-risk groups for HIV transmission due to their complex and secretive sexual relationships, posing challenges to HIV prevention.

Objective:

We aimed to analyze the molecular network clustering factors and characterize pretreatment HIV drug resistance (PDR) of HIV-infected individuals among MSM in Baotou City.

Methods:

This study was conducted retrospectively from 2022 to 2024. 213 samples were collected from newly diagnosed HIV-1-positive patients who had not previously received treatment. By utilizing the reverse transcription polymerase chain reaction (RT-PCR) technique to amplify the 1.3 kb target sequence within the pol gene, we generated a maximum likelihood (ML) phylogenetic tree and a molecular transmission network. These tools allowed us to delve into the analysis of different subtypes and identify clusters responsible for transmission. Cytoscape software visualizes molecular networks, and logistic regression analysis is used to detect factors related to clustering. PDR was analyzed using the Stanford University HIV Drug Resistance Database.

Results:

A total of 176 pol gene sequences were successfully obtained (89.0%, 176/213), including 7 HIV-1 genotypes and 4 CRFs. CRF07_BC was the most common subtype, accounting for 56.82% (100/176) of the total sequences, followed by CRF01_AE (28.98%, 51/176), CRF55_01B (5.68%, 10/176), B (3.41%, 6/176), and others (5.11%, 9/176). The molecular network was constructed at a distance of 0.013, with 52 sequences (29.55%, 52/176) clustering into 19 clusters within the network. Multivariate logistic regression analysis revealed that individuals infected with the CRF07_BC genotype had a significantly higher risk of clustering (AOR = 4.98, P < 0.01); compared with single individuals, divorced or widowed individuals had a lower likelihood of clustering cases (AOR = 0.27, P < 0.05). The prevalence of PDR was 6.57% (14/213), primarily involving NNRTIs, with clustering of resistant strains. Drug resistance mutation sites included K103, Q58, L100, D67, M46, N83, T215, K70, S68, P225, F227.

Conclusions:

Our results revealed the clustering of CRF07_BC among MSM in Baotou and high levels of resistance to non-nucleoside reverse transcriptase inhibitors (NNRTIs). The genotype and marital status are factors influencing molecular network clustering in this region. The PDR among MSM was relatively moderate. We need to be vigilant about the possibility of widespread transmission of CRF07_BC drug-resistant strains in the local area in the future.