Discordant genotypic resistance and HIV-1 genetic diversity from paired plasma and cerebrospinal fluid samples in Chinese settings.

In the highly active antiretroviral therapy era, the incidence of human immunodeficiency virus (HIV)-associated neurocognitive disorder remains high with the improved survival. The prevalence of resistance differs across geographical areas and HIV subtypes. Currently, little information on the resistance patterns in the central nervous system (CNS) is available in Chinese settings. In this study, we sequenced and analyzed the pol gene from paired cerebrospinal fluid and plasma samples of 34 Chinese HIV-infected patients. We found that eight subjects harbored mutations that confer drug resistance, and of these, six subjects exhibited discordant resistance patterns between the CNS and the blood. The levels of viral diversity in the CNS were significantly higher than those in the blood (p < 0.0001). Our results contribute to improving our understanding of HIV neuropathogenesis and help to optimize neuro-acquired immunodeficiency syndrome treatment.