Analysis on the HIV-1 molecular transmission characteristics of newly confirmed HIV/AIDS in Jiaxing city, 2017-2018

Abstract

Objective: To analyze the relationship between infection and transmission of HIV/AIDS, explore the characteristics of the HIV-1 transmission network, and provide evidence for formulating targeted prevention and control measures. Methods: The newly confirmed HIV/AIDS in Jiaxing from 2017 to 2018 were selected for the study. The sociodemographic and infection transmission-related information was gathered. The blood samples were collected and RNA was extracted, RT-PCR and nested PCR amplified the pol gene of HIV-1. The phylogenetic tree was constructed by Mega 6.0 software for subtype analysis. The genetic distance between strains was calculated, and the molecular transmission network was drawn by using Cytoscape 3.6.0 software. The results of the epidemiological study based on the molecular transmission network were analyzed. Results: There were fifteen HIV-1 gene subtypes in 517 cases of HIV/AIDS. The main subtypes were CRF01_AE (37.1%)、CRF07_BC (36.2%) and CRF08_BC (11.8%). Under the 1.0% gene distance threshold, 87 molecular clusters were established, and the total clustering rate was 45.8% (237/517). The cluster risk factors were 60-81 age group (compared with 14-24 age group, OR=2.690, 95%CI:1.058-6.844), married (compared with unmarried, OR=1.698, 95%CI:1.003-2.875), CRF07_BC subtype (compared with CRF01_AE, OR=2.203, 95%CI:1.426-3.404). The largest molecular cluster, CRF07_BC-1, consisted of 50 cases (including 21 cases confirmed in 2017 cases and 29 confirmed in 2018). Multivariate analysis showed that characteristics of unmarried (compared with married, OR=2.482, 95%CI:1.140-5.402), gays (compared with heterosexual, OR=3.163, 95%CI:1.543-6.483), cases with high-risk transmission (compared with other cases, OR=7.631, 95%CI:1.783-32.654), confirmed in Nanhu and Pinghu districts of Jiaxing (compared with other districts, OR=2.225, 95%CI:1.074-4.608) were risks for entering the largest molecular cluster. There were seven suspected high-risk transmission MSM in the largest molecular cluster. The first debut of homosexual behavior was from 2010 to 2018, and the median number of gay partners was 20 (P25, P75：10, 100) within two years before being diagnosed. Six reported a recent history of looking for gay partners in an MSM dating place in Nanhu district. Conclusions: The HIV-1 subtypes of newly confirmed HIV/AIDS were diverse, mainly sporadic in Jiaxing from 2017 to 2018. There were geographical aggregation characteristics and suspected some high-risk transmission cases, suggesting that rapid transmission and targeted intensive intervention are needed.