Abstract
In recent years, the population of men who have sex with men (MSM) have become the most significant increasing group of HIV-1 transmission in China. To identify new recombinant strains and transmission patterns of HIV-1 in Chinese MSM population, a cross-sectional investigation of MSM in Anhui Province (in south-eastern China) was performed in 2011. The diagnosed AIDS case rate, CD4 T-cell counts, HIV subtypes, and origin of the recombinant strains were investigated in 138 collected samples. The phylogenetic and bootscan analyses demonstrated that, apart from three previously reported circulating strains (CRF07_BC, CRF01_AE, subtype B), various recombinant strains among subtype B, subtype C, CRF01_AE, and CRF07_BC were simultaneously identified in Chinese MSM for the first time. The introducing time of B subtype in Chinese MSM populations was estimated in 1985, CRF01_AE in 2000, and CRF07_BC in 2003; the latter two account for more than 85% of MSM infections. Notably, in comparison with B subtype infections in Anhui MSM, CRF01_AE, with the highest prevalence rate, may accelerate AIDS progression. Over half of patients (56%) infected with new recombinant strains infection are diagnosed as progression into AIDS. Both Bayes and phylogenetic analyses indicated that there was active HIV transmission among MSM nationwide, which may facilitate the transmission of the new 01B recombinant strains in MSM. In conclusion, new recombinant strains and active transmission were identified in the Chinese MSM population, which may lead to a new alarming HIV pandemic in this population due to the increased pathogenesis of the newly emerging strains.
Highlights
As of 2011, there are 780,000 people in China infected with HIV. 59.0% of these individuals received this virus through sexual transmission: 44.3% through heterosexual transmission and 14.7% through homosexual transmission [1]
Some patients of Anhui men who have sex with men (MSM) had lived and worked in other provinces where they became infected. They moved to Anhui recently and were followed by us (Table 2). In some extent, these immigrants may facilitate the linkage of HIV-1 strains among different provincial MSM populations
Based on the characteristics described above, the participants recruited in Anhui are broadly representative of Chinese MSM population across the country under currently booming economical development
Summary
As of 2011, there are 780,000 people in China infected with HIV. 59.0% of these individuals received this virus through sexual transmission: 44.3% through heterosexual transmission and 14.7% through homosexual transmission [1]. Molecular epidemiological investigations of HIV-1 were performed in MSM from Beijing and local cities in Liaoning, Hebei and Henan provinces [8,9,11,12,13] These studies all indicated similar epidemic conditions, with multiple circulating HIV-1 subtypes (including B, CRF07_BC, CRF01_AE) in different provincial MSM populations in China, making it possible for recombinant events to potentially occur in the MSM population. A phylogeographical tree was constructed to examine the transmission linkage and estimate the time of the most recent common ancestor (tMRCA) of different epidemic regions in Chinese MSM These results will be useful for evaluating the risk of a potential new wave of HIV transmission in the Chinese MSM population
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