Objective To understand the genotypes and drug resistance of HIV-1 in Hongkou district of Shanghai in 2021, and provide data support for establishing HIV-1 drug resistance database and adjusting prevention and treatment strategies of acquired immune deficiency syndrome in time.

Methods Plasma samples of HIV-1 positive patients were collected from January to December, 2021, and the Pol gene of HIV-1 was amplified by reverse transcription-nested PCR. The genotypes of HIV-1 were identified by COMET tool and phylogenetic tree, and the drug resistance was analyzed by Stanford University HIV Drug Resistance Database.

Results A total of 143 Pol sequences and 10 genotypes were obtained. The HIV-1 genotypes included CRF01_ AE, CRF07_ BC, C, B, CRF08_ BC, CRF55_ 01B, CRF67_ 01B, CRF68_ 01B, A, and URFs, accounting for 34.27%, 36.36%, 9.09%, 6.29%, 6.29%, 2.80%, 1.40%, 0.70%, 0.70%, and 2.10%, respectively. It was found that the rate of pretreatment HIV drug resistance (PDR) was 10.49% (15/143). The PDR rate of non-nucleoside reverse transcriptase inhibitors was 6.29% (9/143). The PDR rate of nucleoside reverse transcriptase inhibitors was 1.40% (2/143). The PDR rate of protease inhibitors (PIs) was 2.80% (4/143). The PDR rate of rilpivirine, nevirapine and efavirenz were 4.90%, 3.50% and 3.50%, respectively. In addition, the rate of transmitted HIV drug resistance (TDR) was 4.20% (6/143), and the TDR mutations were detected at M46I, M184V, K103N, K101E and Y181C, which were predicted to be highly resistant to efavirenz, nevirapine, emtricitabine and lamivudine.

Conclusion The genotypes of HIV-1 in Hongkou are becoming increasingly diverse. Therefore, surveillance for HIV-1 genotypes and drug-resistant strains, especially the PDR and TDR associated with non-nucleoside reverse transcriptase inhibitors, should be further strengthened.