Patterns and risk of HIV-1 transmission network among men who have sex with men in Guangxi, China

Xianwu Pang,Qin He,Ningye Fang,Qiuying Zhu,Mei Lin,Shujia Liang,Zhiyong Shen,Xinjuan Zhou,Guanghua Lan,Jinghua Huang,Xiuling Wu,Hui Wei,Kailing Tang

doi:10.1038/s41598-020-79951-2

Abstract

The prevalence of HIV-1 in Guangxi is very high, and the rate of HIV-1 infection among men who have sex with men (MSM) has been increasing. Therefore, it is necessary to explore the patterns and risk factors of HIV transmission in Guangxi. For this purpose, individuals diagnosed with HIV-1 during 2013–2018 in Guangxi were recruited. Phylogenetic relationship, transmission clusters, and genotypic drug resistance analyses were performed based on HIV-1 pol sequences. Related factors were analysed to assess for their association with HIV-1 transmission. CRF07_BC (50.4%) and CRF01_AE (33.4%) were found to be the predominant subtypes. The analysed 1633 sequences (50.15%, Guangxi; 49.85%, other provinces) were segregated into 80 clusters (size per cluster, 2–704). We found that 75.3% of the individuals were in three clusters (size ˃ 100), and 73.8% were high-risk spreaders (links ≥ 4). Infection time, marital status, and subtype were significantly associated with HIV-1 transmission. Additionally, 80.2% of recent infections were linked to long-term infections, and 46.2% were linked to other provinces. A low level of transmitted drug resistance was detected (4.8%). Our findings indicated superclusters and high-risk HIV-1 spreaders among the MSM in Guangxi. Effective strategies blocking the route of transmission should be developed.

Highlights

Human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) continues to be among the most important threats to public health in China
We explored the molecular epidemiological characteristics and genetic transmission network of HIV-1 among men who have sex with men (MSM) in Guangxi by molecular analyses, which will be useful for implementing HIV intervention strategies
All the MSM who were diagnosed with HIV-1 at voluntary counselling and testing clinics in Guangxi, China from January 2013 to December 2018, and who had not been treated with antiviral therapy were enrolled in the study

Summary

Introduction

Human immunodeficiency virus (HIV)/acquired immunodeficiency syndrome (AIDS) continues to be among the most important threats to public health in China. There are no reports of the HIV-1 transmission network among MSM in Guangxi. Comparisons among individuals were based on the following factors: year diagnosed, domicile region, age, marital status, educational level, ethnicity, HIV subtype, and when infection occurred.

Results

Conclusion