Abstract
Recent data on non-B subtypes’ epidemiology among patients infected with human immunodeficiency virus-1 (HIV-1) in Korea are lacking. We aimed to assess the changing trends in the epidemiology of non-B subtypes of HIV-1 in Korea using phyloepidemiological analyses. We analyzed the demographic records and sequencing data obtained from genotypic drug resistance tests between 2005 and 2019 from 517 patients infected with HIV attending a tertiary care hospital in Busan, Korea. Subtyping and phylogenetic analyses with reference sequences were performed. Additionally, transmission clusters were identified via maximum-likelihood trees. Non-B subtypes accounted for 21.3% of the 517 sequences. CRF01_AE (52.7%) was the most common non-B subtype, followed by CRF02_AG (16.4%), A1 (11.8%), and C (5.5%). The prevalence of non-B subtypes decreased from 36.4 to 13.4% by 2009, while it increased to 27.4% between 2015 and 2019. Among patients with non-B subtypes, the proportion of overseas sailors decreased from 66.7 to 7.5%; contrarily, the proportion of men-who-have-sex-with-men (MSM) increased from 0 to 46.9% over the study period. We identified 8 transmission clusters involving non-B subtypes, with sizes ranging from 2 to 4 patients, including 3 clusters containing MSM. Our results highlight the changes in the epidemiological trends of non-B subtypes of HIV-1 in Korea.
Highlights
Recent data on non-B subtypes’ epidemiology among patients infected with human immunodeficiency virus-1 (HIV-1) in Korea are lacking
MSM are increasingly identified as the major high-risk groups in the B k epidemic in K orea[10]. These findings showed that the HIV-1 subtype distribution in association with changes in the socio-demographic determinants of the HIV infection has dynamically changed over time in Korea
Several demographic features differed between patients with HIV-1 non-B subtypes and those with subtype B
Summary
Recent data on non-B subtypes’ epidemiology among patients infected with human immunodeficiency virus-1 (HIV-1) in Korea are lacking. Among patients with non-B subtypes, the proportion of overseas sailors decreased from 66.7 to 7.5%; contrarily, the proportion of men-who-have-sex-with-men (MSM) increased from 0 to 46.9% over the study period. Since the first case of the human immunodeficiency virus (HIV) infection was reported in Korea in 1984, the number of patients with HIV has steadily increased[1]. As of December 2019, the cumulative number of patients with HIV infection in Korea, including non-ethnic Koreans, was 18,724, and more than 1000 new HIV cases have been reported annually since 2 0132. Variables Median age, years Sex Male Female Ethnicity Koreans Non-Koreans Marriage Unmarried Ever-married Unknown Route of transmission Heterosexual MSM Unknown Occupation Ever OSs Ever OWs Former FSWs Median CD4 cell counts (/μL) ARTART-naïve ART-experienced Year of HIV diagnosis 1988–1999 2000–2004 2005–2009 2010–2014 2015–2019
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