HIV Subtypes and Drug-resistance-associated Mutations in US Blood Donors, 2015-2020

Area of Science:

• Virology
• Epidemiology
• Public Health

Background:

• Monitoring human immunodeficiency virus (HIV) genotypes in blood donors can offer insights into infection trends within the general population.
• Understanding HIV genetic diversity is crucial for public health surveillance and treatment strategies.

Purpose of the Study:

• To analyze the genetic diversity and drug resistance mutations (DRM) of HIV in blood donors.
• To assess whether HIV genotypes in blood donors are representative of the general US population.

Main Methods:

• HIV RNA was extracted from positive blood donor plasma samples.
• Nested real-time polymerase chain reaction and next-generation sequencing were used for genome analysis.
• Sequences were compared to the Los Alamos National Laboratory (LANL) database and assessed for DRM using the Stanford HIV DRM Database.

Main Results:

• Out of 743 HIV-positive donations, 563 (75.8%) were successfully sequenced, predominantly subtype B (543 samples).
• HIV genotypes in blood donors showed no significant difference from available LANL genotypes and were similar for newly acquired versus prevalent infections.
• Drug resistance mutations (DRM) were identified in 21.6% of samples, with non-nucleoside reverse transcriptase inhibitor DRM being the most common (14.0%).

Conclusions:

• HIV genetic diversity and DRM in US blood donors appear representative of circulating HIV infections.
• Blood donor data may provide valuable insights into HIV infection diversity, especially for recently transmitted infections, potentially offering more current information than the LANL database.