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. 2024 Jun 17;11(7):ofae343.
doi: 10.1093/ofid/ofae343. eCollection 2024 Jul.

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

Brian Custer  1   2 , Eda Altan  1 , Leilani Montalvo  1 , Alison Coyne  1 , Eduard Grebe  1 , Xutao Deng  1   2 , Mars Stone  1   2 , Eric Delwart  1   2 , Sonia Bakkour  3 , Benyam Hailu  4 , Rita Reik  5 , Debra Kessler  6 , Susan L Stramer  7 , Michael P Busch  1   2 ; Transfusion Transmissible Infections Monitoring System (TTIMS) Program
Collaborators, Affiliations

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

Brian Custer et al. Open Forum Infect Dis. .

Abstract

Background: Monitoring genotypes of HIV infections in blood donors may provide insights into infection trends in the general population.

Methods: HIV RNA was extracted from plasma samples of blood donors confirmed as HIV positive by blood screening nucleic acid and antibody tests. HIV genome target regions were amplified using nested real time-polymerase chain reaction followed by next-generation sequencing. Sequences were compared to those in the Los Alamos National Laboratory (LANL) database. Sequences were also assessed for drug resistance mutations (DRM) using the Stanford HIV DRM Database.

Results: From available HIV-positive donations collected between 1 September 2015 and 31 December 2020, 563 of 743 (75.8%) were successfully sequenced; 4 were subtype A, 543 subtype B, 5 subtype C, 1 subtype G, 5 circulating recombinant forms (CRF), and 2 were subtype B and D recombinants. Overall, no significant differences between blood donor and available LANL genotypes were found, and the genotypes of newly acquired versus prevalent HIV infections in donors were similar. The proportion of non-B subtypes and CRF remained a small fraction, with no other subtype or CRF representing more than 1% of the total. DRM were identified in 122 (21.6%) samples with protease inhibitor, nucleoside reverse transcriptase inhibitor and non-nucleoside reverse transcriptase inhibitor DRMs identified in 4.9%, 4.6% and 14.0% of samples, respectively.

Conclusions: HIV genetic diversity and DRM in blood donors appear representative of circulating HIV infections in the US general population and may provide more information on infection diversity than sequences reported to LANL, particularly for recently transmitted infections.

Keywords: HIV; blood donors; blood screening; genetic sequence analysis; phylogenetics.

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Conflict of interest statement

Potential conflicts of interest. The authors: No reported conflicts of interest. All authors have submitted the ICMJE Form for Disclosure of Potential Conflicts of Interest.

Figures

Figure 1.
Figure 1.
Only subtype B infections are included. (A) Phylogenetic tree comparison of HIV of protease and reverse transcriptase gene sequences from the TTIMS programs and selected LANL reference sequences from 2015–2020. (B) Mean genetic distances comparing TTIMS sequences and LANL references sequences. The violin plot and results of the Kruskal-Wallis (KW) 1-way analysis of variance test show the diversity of the TTIMS HIV sequences are significantly greater than the diversity of available reference sequences from LANL. Reference Genome: GenBank ID K03455.1 Human immunodeficiency virus type 1 (HXB2) complete genome HIV1/HTLV-III/LAV reference genome.
Figure 2.
Figure 2.
Only subtype B infections are included. Phylogenetic tree comparison of HIV protease and reverse transcriptase gene sequences from the TTIMS program according to donor demographic and donation characteristics from 2015–2020. (A) Census region, (B) age group, (C) race/ethnicity, and (D) donation year.
Figure 3.
Figure 3.
Only subtype B infections are included. Mean genetic distances of HIV protease and reverse transcriptase gene sequences from the TTIMS program according to donor demographic and donation characteristics from 2015–2020. Violin plots and results of the Kruskal-Wallis (KW) 1-way analysis of variance test show significant differences in genetic diversity by race/ethnicity, age, and donation year. (A) Census region, (B) age group, (C) race/ethnicity, (D) donation year.
See this image and copyright information in PMC

References

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