LAUSR

OBJECTIVES Fifteen years after the roll-out of antiretroviral treatment (ART) in China, there is limited information available on transmitted HIV drug resistance (TDR). This study aimed to characterize the epidemiology of TDR in China. DESIGN We conducted a prospective cross-sectional observational study. METHODS We analyzed the demographic, clinical, and virological data of individuals with newly diagnosed HIV infection using data from the Beijing HIV laboratory network collected between 2001 and 2017. We did population-based sequencing of the pol gene on plasma specimens and identified TDR mutations using the World Health Organization list for surveillance of TDR mutations. RESULTS Data on TDR were available for 91% of the 10,115 individuals with newly diagnosed HIV infection tested, of whom 19.2% were from rural areas. The overall prevalence of TDR was 4.1% (95% confidence interval [CI]: 3.7%-4.5%), with a declining trend over the period 2001-2017. In the multivariable analysis, the risk of TDR differed significantly according to sex (odds ratio [OR] for women vs men: 0.41, 95% CI:0.22-0.69, p = 0.002); infection type (OR for CRF07_BC vs CRF01_AE:0.24, 95% CI:0.16-0.36, p < 0.001); and sampling period (OR for 2009-2012 vs 2001-2008: 0.57, 95% CI: 0.41-0.79; p = 0.01), and was significantly higher among individuals from Hebei province than in those from Beijing (OR: 1.43, 95% CI: 1.05-1.96; p = 0.02). CONCLUSIONS In China, the prevalence of TDR among individuals with newly diagnosed HIV infection is relatively low. Trends in TDR should be assessed in other countries with a high TDR burden.