The sexually driven epidemic in youths in China's southwestern border region was caused by dynamic emerging multiple recombinant HIV-1 strains.

Huamian Wei,Yanling Ma,Hui Xing,Cui He,Jenny H Hsi,Lin Lu,Shitang Yao,Xiang He,Manhong Jia,Yi Feng,Yiming Shao,Song Duan,Yunda Huang,Yuhua Ruan,Lingjie Liao

doi:10.1038/srep11323

Abstract

Dehong prefecture, Yunnan province on China’s southwestern border was the gateway of the country’s AIDS epidemic. Studies on HIV-1 molecular epidemiology will provide key information on virus transmission dynamics and help to inform HIV prevention strategies. HIV-1 infected youths (age 16–25 years) diagnosed in the continuous 3 months in 2009 to 2012 were enrolled. By means of phylogenetic and statistical analyses, It was showed that two thirds (133/205) of youths in Dehong, of which 74.1% were infected sexually, were infected by uncharacterized recombinant HIV-1 strains. Among them about 59.4% (79/131) were unique recombinant forms (URFs) and 40.6% (54/131) formed 11 transmission clusters, termed potential circulating recombinant forms (pCRFs). The emergence of recombinants was statistically significant related with people of low education, residents outside the capital city of Dehong and being Myanmar residents. It was the first report with ongoing HIV-1 recombinant strains in a sexually driven epidemic area in China. Great efforts should be put on reducing multiple risk exposures behavior in local young people, containing the spread of pCRFs to other regions, and preventing the URFs from evolving into future CRFs. Collaborative prevention across border is needed to better control the local AIDS epidemic.

Highlights

There is seldom report far on high proportions of recombinant HIV-1 found in sexual transmission networks, which has become the major driving force in China’s current AIDS epidemic
Numerous studies reported high rates of recombinant HIV-1 found in IDUs10,11,24, since the parental strains with greater genetic similarity are more likely to recombine[25]
There is rarely report for high proportions of recombinant HIV-1 strains in sexual driving epidemic in Asia

Summary

Introduction

Dehong prefecture in Yunnan province, southwest China, is considered the gateway of China’s HIV-1 epidemic, from where most of the HIV-1 strains currently circulating in the country had first appeared[4,5,6,7,8,9]. This study design is based on the WHO Threshold Survey for transmitted HIV drug resistance surveillance that sought to capture recent infections by sampling from newly reported HIV infections in people less than 25 years of age. It aims to capture the full picture of the current ongoing epidemic in Dehong through characterizing the scale and patterns of recombinant HIV infections as well as factors related to their cause

Methods

Results

Conclusion