Retrospective analysis of HIV-1 drug resistance mutations in Suzhou, China from 2009 to 2014


In this study, we investigated drug resistance levels in human immunodeficiency virus (HIV)-1-infected patients in Suzhou by retrospectively analyzing this property and the characteristics of circulating HIV-1 strains collected from 2009 to 2014. A total of 261 HIV-1-positive plasma samples, confirmed by the Suzhou CDC, were collected and evaluated to detect HIV-1 drug resistance genotypes using an in-house method. The pol gene fragment was amplified, and its nucleic acid sequence was determined by Sanger sequencing. Drug resistance mutations were then analyzed using the Stanford University HIV resistance database ( A total of 216 pol gene fragments were amplified and sequenced with 16.7% (36/216) of sequences revealing these mutations. The drug resistance rates of protease, nucleoside reverse transcriptase, and non-nucleoside reverse transcriptase inhibitors (NNRTIs) were 4/36 (11.1%), 2/36 (5.6%), and 30/36 (83.3%), respectively. Five surveillance drug resistance mutations were found in 36 sequences, of which, three were found among specimens of men who have sex with men. Potential low-level resistance accounted for 33% of amino acid mutations associated with NNRTIs. Two of the mutations, M230L and L100I, which confer a high level of resistance efavirenz (EFV) and nevirapine (NVP) used as NNRTIs for first-line antiretroviral therapy (ART), were detected in this study. Therefore, when HIV-1 patients in Suzhou are administered fist-line ART, much attention should be paid to the status of these mutations that cause resistance to EVP, EFV, and NVP.

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We gratefully acknowledge the contribution of the HIV-1 patients who participated in this study and also wish to thank the staff of the local CDC for recruiting participants, collecting samples, and technical assistance.


This work was supported by The National Natural Science Foundation of China (81802083, 31870867), State Key Laboratory of Veterinary Biotechnology Foundation (SKLVBF201916), Open Research Fund Program of the State Key Laboratory of Virology of China (2020IOV003), the Jiangsu Province Medical Innovation Team (CXTDB2017009), the Jiangsu Province's Key Discipline of Prenatal Diagnosis (FXK201746), and Jiangsu Provincial Key Research and Development Program (BE2019656).

Author information




RL and XY collected the samples. YS and JHu designed the study, YS, JH, JH, YY, and YL performed the experiments. YS analyzed the data. YS and CD wrote the manuscript.

Corresponding author

Correspondence to Yanhui Song.

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Conflicts of interest

The authors declare that they have no conflicts of interest regarding this work.

Ethical approval

This study has been approved by the Ethics Committee of the First Affiliated Hospital of Soochow University.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Sequence data

The 216 pol sequences analyzed in the study have been submitted to GenBank with the accession number MN601502-601717.

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Song, Y., Hu, J., He, J. et al. Retrospective analysis of HIV-1 drug resistance mutations in Suzhou, China from 2009 to 2014. Virus Genes (2020).

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  • HIV-1
  • Epidemiology
  • Drug resistance mutation
  • Antiretroviral therapy
  • China