Abstract
BackgroundAs a gateway for HIV-1 in China, Yunnan has experienced dramatic changes in HIV-1 epidemics, during which HIV-1 genotypes have become complex. To track dynamic changes in HIV-1 genotypes, an HIV-1 molecular epidemiological study was implemented in the recently infected population in Yunnan.MethodsFrom 6,357 HIV-1-positive samples diagnosed during the first half of 2015 in Yunnan, 586 samples were identified as recent infections with BED-capture enzyme immunoassay (CEIA) and were subjected to phylogenetic analyses. Spatial scanning analyses for the main HIV-1 genotypes were also performed.ResultsAmong the 439 specimens successfully genotyped, more than ten genotypes were detected, including CRF08_BC (45.3%), CRF07_BC (19.4%), unique recombinant forms (URFs) (18.2%), CRF01_AE (11.4%), subtype C (2.1%), CRF85_BC (1.1%), CRF55_01B (0.9%), subtype B (0.5%), CRF64_BC (0.5%), CRF59_01B (0.2%), CRF83_cpx (0.2%) and CRF87_cpx (0.2%). Females, Chinese, heterosexual contact and intravenous drug injection were significantly associated with CRF08_BC infection; homosexual contact was significantly associated with CRF01_AE and CRF07_BC infection; males and non-Chinese had a higher risk of URF infection than females. Among all HIV-1 genotypes, the geographic coverage of CRF08_BC was the largest. For CRF08_BC, CRF07_BC, URFs and CRF01_AE, spatial clusters were detected. The two CRF08_BC clusters and one URF cluster were associated with heterosexual transmission, and two of CRF01_AE clusters were associated with homosexual transmission. Transmitted drug resistance (TDR)-associated mutations were detected in 2.4% of individuals.ConclusionsThe diversity of HIV-1 genotypes increased in recent infections because of a long-term HIV-1 epidemic in Yunnan. The predominant HIV-1 strains showed distinct demographic characteristics and formed spatial clusters. These findings improved our understanding of the evolution of HIV-1 in Yunnan and provided information for further HIV-1 control and prevention.
Highlights
As a gateway for Human immunodeficiency virus-1 (HIV-1) in China, Yunnan has experienced dramatic changes in HIV-1 epidemics, during which HIV-1 genotypes have become complex
Since HIV-1 was first identified among intravenous drug users (IDUs) in western Yunnan in 1989, HIV-1 epidemics have dramatically increased in Yunnan [1,2,3]
Based on information regarding disease progression and a BEDCEIA assay, 586 samples were identified as recent infections and were subjected to HIV-1 gene amplification
Summary
As a gateway for HIV-1 in China, Yunnan has experienced dramatic changes in HIV-1 epidemics, during which HIV-1 genotypes have become complex. To track dynamic changes in HIV-1 genotypes, an HIV-1 molecular epidemiological study was implemented in the recently infected population in Yunnan. Since HIV-1 was first identified among intravenous drug users (IDUs) in western Yunnan in 1989, HIV-1 epidemics have dramatically increased in Yunnan [1,2,3]. In the 1990s, CRF07_BC and CRF08_ BC formed through the recombination of subtype B and subtype C, which were circulating among IDUs in Yunnan and transmitted along drug trafficking routes [9, 10]. The main HIV-1 genotypes spread from the original areas to other areas of Yunnan. CRF01_AE was transmitted from western to eastern Yunnan, and CRF08_BC and CRF07_BC were transmitted from southeast of Yunnan to other areas
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