Abstract
ObjectiveTo examine the distribution of HIV-1 genotypes among injecting drug users (IDUs) from Dehong, Yunnan province.Materials and MethodsBlood samples from a total of 95 HIV-positive IDUs were retrospectively analyzed. Samples were collected between 2005 and 2009 from four cities in Dehong prefecture, western Yunnan province, the geographical origin of the HIV epidemic in China. HIV-1 gag, partial pol, vpr-env fragment, half-genome, or near-full-length sequences were analyzed to determine the HIV-1 genotypes of each subject. Results were compared with findings from past studies of IDUs in Dehong and in neighboring Myanmar.ResultsWe observed a high prevalence of B′/C recombinants (82.4%) among IDUs in Dehong, the structural profiles of which do not match those previously reported in Dehong or in Myanmar. Furthermore, statistically significant differences in geographical and temporal distributions of HIV-1 genotypes were characterized by a predominance of HIV-1 B′/C recombinant forms among older subjects(p = 0.034), subjects from Longchuan district (p = 0.022), and subjects diagnosed between 2000 and 2004 (p = 0.004).ConclusionsThe increasing prevalence of multiple, new B′/C recombinant forms suggest that HIV-1 intersubtype recombination is substantial and ongoing in western Yunnan. This reflects the high-risk behavior of IDUs in this region and argues the need for stronger monitoring and prevention measures in Dehong and other high-prevalence areas around China.
Highlights
Yunnan province, located in southwestern China, was the first province to report evidence of an HIV epidemic and remains the most severely affected area in China today
We observed a high prevalence of B9/C recombinants (82.4%) among injecting drug users (IDUs) in Dehong, the structural profiles of which do not match those previously reported in Dehong or in Myanmar
Statistically significant differences in geographical and temporal distributions of HIV-1 genotypes were characterized by a predominance of HIV-1 B9/C recombinant forms among older subjects(p = 0.034), subjects from Longchuan district (p = 0.022), and subjects diagnosed between 2000 and 2004 (p = 0.004)
Summary
Yunnan province, located in southwestern China, was the first province to report evidence of an HIV epidemic and remains the most severely affected area in China today. The Dehong, DaiJingpo autonomous prefecture is one of eight minority autonomous prefectures in Yunnan province. According to China’s 2010 national census, Dehong prefecture had a total population of approximately 1.2 million people with 49% belonging to minority groups, including Dai, Jingpo, Achang, Lisu, and Deang. Dehong encompasses an area of 11,526 square kilometers, divided into five districts: Luxi, Ruili, Longchuan, Yingjiang, and Lianghe (Figure 1A). Except for Lianghe, each district shares a border with Myanmar. Commerce, and intermarriage across the China-Myanmar border are common in this region
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