The risk of HIV transmission from blood transfusion is low (0.16 to 0.49 per million transfusions) but is still possible due to the viral window period during which newly acquired infections are not detected by diagnostic screening methods. In Poland, the frequency of HIV-positive blood donors and donations per 100,000 was 6.6 and 3.3, respectively. Therefore, constant hemovigilance is needed to identify pre-seroconversion infections, but samples can also be used to study HIV genetic diversity and drug resistance patterns. To this end researchers in Poland analyzed HIV positive blood donations collected between 2009 and 2017 (N=235, 96% male). Three genes were sequenced—HIV-1 protease (PR), reverse transcriptase (RT), and HIV-1 integrase (IN)—and HIV subtypes were analyzed phylogenetically and for drug resistance mutation (DRM) patterns. As expected, HIV-1 subtype B was predominate (89.2%) followed by subtype A6 (7.6%). New recombinant variants were identified in three cases (1.6%). Furthermore, nucleoside inhibitor and non-nucleoside drug resistance was observed in 3.8% and 0.6% of cases. Integrase strand transfer inhibitor (INSTI) was observed in 1.1% of cases and may be emerging in Poland. Tracking HIV drug resistance and mutations in blood donations is an effective tool for monitoring newly emerging HIV subtypes.
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