Abstract
BackgroundYunnan has the longest endured Human Immunodeficiency Virus-1 (HIV-1) epidemic in China, and the genetic diversity of HIV-1 constitutes an essential characteristic of molecular epidemiology in this region. To obtain a more comprehensive picture of the dynamic changes in Yunnan’s HIV-1 epidemic, a cross-sectional molecular epidemiological investigation was carried out among recently infected individuals.Methodology/Principal FindingsWe sequenced partial gag (HXB2∶781–1861) and env (HXB2∶7002–7541) genes from 308 plasma samples of recently infected patients. With phylogenetic analysis, 130 specimens generated interpretable genotyping data. We found that the circulating genotypes included: CRF08_BC (40.8%), unique recombinant forms (URFs, 27.7%), CRF01_AE (18.5%), CRF07_BC (9.2%), subtype B (2.3%) and C (1.5%). CRF08_BC was the most common genotype, and was predominant in both intravenous drug users (IDUs) and heterosexually transmitted populations. CRF08_BC and CRF07_BC still predominated in eastern Yunnan, but CRF08_BC showed increasing prevalence in western Yunnan. Strikingly, the URFs raised dramatically in most regions of Yunnan. Seven different types of URFs were detected from 12 prefectures, suggesting that complicated and frequent recombination is a salient feature of Yunnan’s HIV-1 epidemic. Among URFs, two BC clusters with distinctive recombination patterns might be potential new CRF_BCs. CRF01_AE was no longer confined to the prefectures bordering Myanmar, and had spread to the eastern part of Yunnan, especially the capital city of Kunming, with a large number of infections in the transient population. The ratios of the main genotypes showed no statistical differences between infected IDUs and heterosexually transmitted infections.Conclusions/SignificanceThe changing patterns of the dominant HIV-1 genotypes in Yunnan indicate the complex evolving dynamic nature of the epidemic. Understanding new trends in molecular epidemiology of HIV-1 infection is critical for adjusting current prevention strategies and vaccine development in Yunnan.
Highlights
Yunnan is located in southwestern China and has 16 prefectures and 129 counties
Demographic Characteristics of Study Subjects A total of 3034 newly diagnosed Human Immumodeficiency Virus (HIV)-positive samples were collected from voluntary counseling and testing sites (VCT), medical case reports and sentinel surveillance in Yunnan Province during the first quarter of 2009
308 samples were identified as recent infections, all of which were used for the Human Immunodeficiency Virus-1 (HIV-1) genetic analysis
Summary
Yunnan is located in southwestern China and has 16 prefectures and 129 counties. Yunnan borders Myanmar, Laos and Vietnam and is situated along the drug trafficking routes that channel heroin into China from southeast Asia’s opiumproducing ‘‘Golden Triangle’’ region. In 1989, the first Human Immumodeficiency Virus (HIV) epidemic in China was identified among intravenous drug users (IDUs) in Ruili County of Dehong Prefecture [1]. Yunnan has been one of the areas most affected by HIV in China. Yunnan serves as a primary entry point for the introduction of different HIV-1 genotypes into China. Yunnan is considered as an epicenter of the HIV-1 epidemic in China. Yunnan has the longest endured Human Immunodeficiency Virus-1 (HIV-1) epidemic in China, and the genetic diversity of HIV-1 constitutes an essential characteristic of molecular epidemiology in this region. To obtain a more comprehensive picture of the dynamic changes in Yunnan’s HIV-1 epidemic, a cross-sectional molecular epidemiological investigation was carried out among recently infected individuals
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