Abstract
Although the Guangxi region accounts for 10% of all HIV-1 cases new reported in 2011 in China, the sources of the transmitted HIV-1 strains are virtually unknown. To determine the extent to which recent HIV infections were derived from already circulating local strains as opposed to recently introduced strains, we performed a cross-sectional molecular epidemiological investigation of recent infections across Guangxi during 2012–2013. HIV-1 nucleotide sequences were amplified and sequenced. Phylogenetic analyses of pol gene regions were used to determine HIV-1 transmission source strains. Based on 229 sequences generated, the subtype/CRF distribution was as follows: CRF01_AE (61.1%), CRF07_BC (18.8%), CRF08_BC (16.6%), CRF55_01B (3.1%), and subtype B′ (0.4%). In total, 213 of 229 (93.0%) sequenced transmission strains were derived from already-circulating local strains. Multivariate logistic regression analysis showed that only an age of 18–25 years was significantly associated with transmission from outside Guangxi (compared to >25 years, AOR: 5.15, 95% CI: 1.18–22.48, p < 0.01). This is the first study to use a Bayesian discrete phylogeographic approach to analyze transmission source strains in China. Our results provide useful data for designing evidence-based prevention strategies and methods for combating the rapid spread of sexually transmitted HIV in Guangxi.
Highlights
The Guangxi region accounts for 10% of all human immunodeficiency virus (HIV)-1 cases new reported in 2011 in China, the sources of the transmitted HIV-1 strains are virtually unknown
Among 275 plasma samples from individuals recently infected with HIV-1 from 2012 to 2013, pol sequences were successfully amplified and genotyped from a total of 229 samples (83.3%)
Traditional field epidemiological surveys focusing on HIV infection and related risk factors have been conducted, this is the first study to use molecular epidemiology to track the sources of HIV transmission strains among recently infected individuals in China
Summary
The Guangxi region accounts for 10% of all HIV-1 cases new reported in 2011 in China, the sources of the transmitted HIV-1 strains are virtually unknown. Multivariate logistic regression analysis showed that only an age of 18–25 years was significantly associated with transmission from outside Guangxi (compared to >25 years, AOR: 5.15, 95% CI: 1.18–22.48, p < 0.01) This is the first study to use a Bayesian discrete phylogeographic approach to analyze transmission source strains in China. CRF01_AE, originated in central Africa in the 1970s and spread in Thailand in the 1980s through heterosexual transmission[12,13], first identified among IDUs in Guangxi, showed significant clustering with strains found in northern Vietnam[6,14]. A national molecular epidemiological survey conducted across China in 2006 showed that there were three major HIV-1 subtypes circulating in Guangxi, i.e., CRF01_AE, CRF08_BC, and CRF07_BC, accounting for 60.0%, 29.1%, and 6.4% of cases, respectively[15]. We further used bioinformatics approaches to analyze the sources of HIV-1 transmission strains in Guangxi, China
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