Acquisition and transmission of HIV-1 among migrants and Chinese in Guangzhou, China from 2008 to 2012: Phylogenetic analysis of surveillance data.

Abstract

Post-migration infection and domestic transmission of HIV-1 between immigrants and local population are critical for the HIV epidemic, but have not been addressed thus far in China. Transmission clusters were analyzed with two cluster reconstruction methods, HIV-TRACE and Cluster Picker, using 1695 HIV-1 pol sequences obtained from 139 HIV-infected foreigners and 1556 Chinese natives in Guangzhou, China from 2008 to 2012. The geographic origin of the HIV-1 sequences was further determined by PastML while the factors associated with recent HIV-1 transmission were documented by logistic regression analysis. HIV-1 genotypes that are prevalent in African and East Asian countries were identified in HIV-infected Chinese subjects and vice versa. In addition, more NRTI drug resistance mutations were found in HIV-infected foreigners than in native Chinese (p<0.001). HIV-1 transmission between HIV-infected foreigners and native Chinese individuals was documented in 12.95% (18/139) of the HIV-infected foreigners. Furthermore, Asian (odds ratio [OR]=3.45), male (OR=16.88) and those with known HIV-1 infection routes (OR=3.23) were more likely associated with recent HIV-1 transmission in China. The Chinese natives linked to recent HIV-1 transmission were more likely to be infected through men who have sex with men (OR=3.05) or people who inject drugs (OR=3.05), rather than by heterosexual transmission. Our study demonstrates the impact of recent HIV-1 transmission between HIV-infected foreigners and Chinese natives on the HIV-1 epidemic in Guangzhou, China. Moreover, the results highlight the importance of phylogenetic analysis of HIV-1 surveillance data and the need for specific prevention strategies that target the immigrant population.