Expanded evaluation of blood donors in the United States for human immunodeficiency virus type 1 non-B subtypes and antiretroviral drug-resistant strains: 2005 through 2007

BACKGROUND: In a previous study of 66 human immunodeficiency virus (HIV)‐infected US blood donors from 1999 to 2005, HIV‐1 non‐B and antiretroviral drug–resistant strains accounted for 4.7 and 6.5% of HIV infections, respectively. This study was expanded to include an additional 11 recently acquired infections and 197 established infections collected from January 2005 through December 2007. STUDY DESIGN AND METHODS: HIV‐infected donors were detected using FDA‐licensed assays. Drug resistance profiles for protease and reverse transcriptase (RT) genes were determined using a genotyping system (ViroSeq, Celera Diagnostics); genetic subtype was determined by phylogenetic analysis of these sequences. RESULTS: Drug resistance profiles were obtained for 203 of 208 specimens; 9.9% had mutations that confer drug resistance. Ten showed resistance to a single drug class: nine to nonnucleoside RT inhibitors (NNRTIs) and one to nucleoside RT inhibitors (NRTIs). Eight showed two drug class resistance: five NRTI plus NNRTI, two NRTI plus protease inhibitor (PI), and one NNRTI plus PI. Two showed three drug class resistance. Non‐B strains were identified in 2.5% of donors and consisted of subtypes A1 and D, CRF02_AG, CRF43‐02G, and URF_BF. CONCLUSIONS: Data from this and the previous study show that antiretroviral drug–resistant HIV‐1 is present in 9.1% of HIV‐infected donors from 1999 through 2007; 9.3% of established infections and 6.9% of recent infections. Diverse HIV‐1 non‐B strains presently account for 3.0% of HIV infections in US donors.