Characteristics of HIV-1 molecular transmission networks and drug resistance among men who have sex with men in Tianjin, China (2014–2018)

Abstract

Background In Tianjin, China, there is a relatively high prevalence of HIV in men who have sex with men (MSM). The number of HIV cases in Tianjin is also increasing. We investigated the HIV molecular transmission network, genetic tropisms, and drug resistance mutations in Tianjin. Methods Blood samples were collected from 510 newly diagnosed antiretroviral therapy (ART)-naïve HIV-1-infected subjects among MSM in Tianjin. Partial pol and env genes were sequenced and used for phylogenetic, genetic tropism, and genotypic drug resistance analyses. Molecular clusters were identified with 1.5% genetic distance and 90% bootstrap support. Results Among the 436 HIV-1 pol sequences obtained from the study participants, various genotypes were identified, including CRF01_AE (56.9%), CRF07_BC (27.8%), B (7.3%), CRF55_01B (4.1%), unique recombinant forms (URFs) (3.7%), and CRF59_01B (0.2%). A higher prevalence of X4 viruses was observed in individuals infected with CRF55_01B (56.3%) and CRF01_AE (46.2%) than with other subtypes. Of all 110 sequences in the 36 clusters, 62 (56.4%) were observed in 23 CRF01_AE clusters and 18 (16.4%) in four CRF07_BC clusters. Eight sequences clustered with at least one other shared the same drug resistance mutation (DRM). In different cluster sizes, the distributions of individuals by age, presence of sexually transmitted disease, and presence of DRMs, were significantly different. Conclusion We revealed the characteristics of HIV molecular transmission, tropism, and DRMs of ART-naïve HIV-infected individuals among the MSM population in Tianjin. Identifying infected persons at risk of transmission is necessary for proposing counseling and treating these patients to reduce the risk of HIV transmission.

Risk Factors of Drug Resistance and the Potential Risk of HIV-1 Transmission of Patients with ART Virological Failure: A Population-Based Study in Sichuan, China

“…Among this network, 761 DR subjects were observed, further analysis showed that 373 (49.01%) of individuals had more than 2 DR-DR links, indicating the presence of the individuals with transmission risk in the network, 22 187 (24.57%) subjects had more than 4 links and were considered high-risk spreaders and more likely to spread HIV-1, one individual had 178 links and was considered a super spreader, which differs from those in other provinces of China. 11 This super spreader is fit with previous studies that individuals with more linkages may have a higher transmission risk because of their high viral load and high risk behavior (ie, inject drug), 22–25 therefore, these individuals may function as super-spreaders. Most of the individuals linked with the super-spreader were from Liangshan, but they had intercity connections with 14 regions.…”

“…indicating the presence of the individuals with transmission risk in the network, 22 187 (24.57%) subjects had more than 4 links and were considered high-risk spreaders and more likely to spread HIV-1, one individual had 178 links and was considered a super spreader, which differs from those in other provinces of China. 11 This super spreader is fit with previous studies that individuals with more linkages may have a higher transmission risk because of their high viral…”

“…Previous studies showed that young men, especially MSM, and some subtypes (eg, CRF55_01B, CRF01_AE) may have a higher transmission risk. 10,11 In addition, reports showed that some demographic differences and HIV-related behaviors (eg, gender differences, ART adherence and ART regimens) lead to the risk of drug resistance with virological failure among PLWH, which were reported among PLWH in some countries, such as China, [12][13][14] Uganda, 15 Malawi, 16 Cameroon. 17 Yuan had reported that DR transmission in MSM with virological failure was concentrated in urban cities.…”

Spatial Analysis of People Living with HIV/AIDS Transmitted Through Commercial Heterosexual Contact or Non-Marital Non-Commercial Heterosexual Contact — China, 2018

“…There was likely some interweaving between these two populations. For example, some men might be engaged in both commercial and nonmarital non-commercial heterosexual behaviors, which may transmit HIV from infected female sex workers (FSWs) to uninfected women in the general population, thereby spreading HIV from high-risk groups to the general population through heterosexual transmission (8). However, in the coastal areas of China, no hotspot for CHC or NMNCHC was identified.…”

“…Consequently, there were fewer sexually transmitted diseases. Nonetheless, this could also be because some large cities in areas such as Beijing or Tianjin have a high prevalence of men who have sex with men (MSM) transmission, accounting for the majority of newly identified PLWHA ( 9 - 10 ). Furthermore, this study discovered that although the overall proportion of heterosexual transmission in Beijing or Tianjin was comparatively small, NMNCHC remained the principal mode of transmission via heterosexual contact in these areas.…”