Impact of worker emigration on HIV epidemics in labour export areas: a molecular epidemiology investigation in Guangyuan, China

Su, Ling; Liang, Shu; Hou, Xueqin; Zhong, Ping; Wei, Dongbing; Fu, Yu; Li, Ye; Xiong, Liang; Zeng, Yao; Ying, Hanjie; Hong, Yuan; Wu, Bo; Zhang, Linglin; Li, Xiaoshan

doi:10.1038/s41598-018-33996-6

Cited by 20 publications

(16 citation statements)

References 27 publications

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“…This result may be due to enhanced economic development and transportation level of Xichang and to the high number of migrants. As a result, individuals in Xichang were likely to link to one another in the transmission network, similar to the results of other studies [ 67 , 68 ]. Interestingly, there was no significant correlation between the transmission route and the clustering rate.…”

Section: Discussionsupporting

confidence: 88%

Survey of Pretreatment HIV Drug Resistance and Genetic Transmission Network Analysis Among HIV Patients in a High Drug-Use Area of Southwest China

Liu¹,

Dong²,

Liao³

et al. 2020

CHR

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Background: Pretreatment drug resistance (PDR) poses an increasing threat to the success of antiretroviral treatment (ART) programs in China. We aimed to conduct a survey of PDR among HIV patients in an area in Southwest China with extensive drug trafficking. Methods: Consecutive cross-sectional surveys were conducted in Liangshan Prefecture of Sichuan Province from 2009 to 2018 based on the WHO-recommended method. PDR was identified by testing pol region sequences with the Stanford HIVdb algorithm (version 7.0). PDR prevalence and related factors were assessed by multivariable logistic regression. The transmission of HIV drug resistance was analyzed using a genetic transmission network. Results: HIV-1 pol genes from 1889 patients were successfully amplified. The distribution of HIV- 1 genotypes was as follows: CRF07_BC (94.0%), CRF08_BC (2.3%), CRF01_AE (2.0%) and others (1.4%). Of the participants, 6.9% (95% CI: 4.1-8.1%) had pretreatment resistance to 12 antiretroviral drugs recommended by the WHO, and nucleoside reverse transcriptase inhibitor (NRTI), non-nucleoside reverse transcriptase inhibitor (NNRTI) and protease inhibitors (PI) resistance were identified among 1.4% (95% CI: 0.7-3.4%), 5.8% (95% CI: 1.2-8.7%) and 0.4% (95% CI: 0.1- 3.0%) of the patients, respectively. In the multivariate logistic model, the prevalence of PDR was 1.52-fold higher among intravenous drug users (IDUs) than among patients infected by heterosexual transmission (95% CI: 1.07-2.38; P=0.049), and the prevalence of PDR among patients diagnosed from 2017-2018 was 2.03-fold higher than that among patients diagnosed from 2009-2016 (95% CI: 1.18-5.76; P=0.018). A total of 26 clusters containing PDR and a rapidly growing drug resistancerelated cluster containing the E138Q and V179D mutations were identified by genetic transmission network analysis. Conclusions: The results show a moderate overall level of PDR prevalence and rapidly growing drug resistance over time. Preventive intervention should be focused on controlling the HIV epidemic among drug users, and surveillance is urgently needed to monitor the trend of PDR.

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Section: Discussionsupporting

confidence: 88%

Survey of Pretreatment HIV Drug Resistance and Genetic Transmission Network Analysis Among HIV Patients in a High Drug-Use Area of Southwest China

Liu¹,

Dong²,

Liao³

et al. 2020

CHR

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“…Importantly, the labor migrant population is also at higher risk for HIV acquisition and transmission because of poor knowledge about self-protection and the transmission routes of HIV (34), and they have been shown to fuel local epidemics (30,35).…”

Section: Introductionmentioning

confidence: 99%

“…~80,000 new infections per year (1) coincided with intense rural-to-urban migration flows(24)(25)(26)(27)(28)(29)(30) on October 14, 2020 at UNIV OF CALIF SAN DIEGO http://jvi.asm.org/ Downloaded from…”

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confidence: 99%

Comparative Circulation Dynamics of the Five Main HIV Types in China

Vrancken

Zhao

et al. 2020

J Virol

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The HIV epidemic in China accounts for 3% of the global HIV incidence. We compared the patterns and determinants of interprovincial spread of the five most prevalent circulating types. HIV pol sequences sampled across China were used to identify relevant transmission networks of the five most relevant HIV-1 types (B, CRF01_AE, CRF07_BC, CRF08_BC and CRF55_01B) in China. From these, the dispersal history across provinces was inferred. A generalized linear model (GLM) was used to test the association between migration rates among provinces and several measures of human mobility. A total of 10,707 sequences between 2004-2017 across 26 provinces were collected, among which 1,962 newly reported here. A mean of 18 (Min-Max:1-54) independent transmission networks involving up to 17 provinces were identified. Discrete phylogeographic analysis largely recapitulate the documented spread of the HIV types which, in turn, to large extent mirror within-China population migration flows. In line with the different spatio-temporal spread dynamics, the identified drivers thereof were also heterogeneous but are consistent with a central role of human mobility. The comparative analysis of the dispersal dynamics of the five main HIV types circulating in China suggests a key role of large populations centers and developed transportation infrastructures as hubs of HIV dispersal. This advocates for coordinated public health efforts in addition to local targeted interventions. IMPORTANCE While traditional epidemiological studies are of great interest in describing the dynamics of epidemics, they cannot fully capture the geospatial dynamics and factors driving the dispersal of pathogens such as HIV as they struggle to capture linkages between infections. To overcome this, we used a discrete phylogeographic approach coupled to a generalized linear model extension to characterize the dynamics and drivers of the across-province spread of the five main HIV types circulating in China. Our results indicate that large urbanized areas with dense population and developed transportation infrastructures are facilitators of HIV dispersal throughout China, and highlight the need to consider harmonized country-wide public policies to control local HIV epidemics.

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“…In 2016, we reported a novel B/C recombinant form, CRF85_BC, among heterosexually infected patients in southern Sichuan (Yibin city) [ 12 ]. CRF85_BC was then reported in Anhui [ 13 ], Yunnan [ 14 ] and Northern Sichuan [ 15 ] (Guangyuan City). Due to lack of B or C epidemic history in the local high-risk population, the origin and the spread of CRF85_BC was still to be investigated.…”

Section: Introductionmentioning

confidence: 99%

The origin and spread of CRF85_BC, driven by heterosexual transmission among older people in Sichuan, China

Feng

Liang

et al. 2020

BMC Infect Dis

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Background CRF_BC recombinants, including CRF07_BC and CRF08_BC, were considered the predominant subtypes in China. Since the discovery of HIV-1 circulating recombinant form CRF 85_BC in Southwest China in 2016, this BC recombinant forms had been reported in different regions of China. However, the history and magnitude of CRF85_BC transmission were still to be investigated. Method We conducted the most recent molecular epidemiology of HIV-1 among newly reported HIV-1 infected patients in Sichuan in 2019 by sequencing and phylogenetic analysis of 1291 pol sequences. Then, we used maximum likelihood approach and the Bayesian Markov chain Monte Carlo (MCMC) sampling of pol sequences to reconstruct the phylogeographic and demographic dynamics of the CRF85_BC. Results HIV-1 CRF85_BC (68/1291, 5.27%) became the fourth most prevalent strain revealing a significant increase in local population. CRF85_BC were only found in heterosexually infected individuals and the majority of CRF85_BC (95.45%) were circulating among the people living with HIV aged 50 years and over (PLHIV50+), suggesting a unique prevalent pattern. The founder lineages of CRF85_BC were likely to have first emerged in Yunnan, a province of Southwest China bordering Sichuan, in the early 2000s. It then spread exponentially to various places (including Guangxi, Sichuan, et al) and became endemic around 2008.6 (2006.7–2010.2) in Sichuan. Conclusion Taken together, our findings on HIV-1 subtype CRF85_BC infections provided new insights into the spread of this virus and extended the understanding of the HIV epidemic in China.

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Impact of worker emigration on HIV epidemics in labour export areas: a molecular epidemiology investigation in Guangyuan, China

Cited by 20 publications

References 27 publications

Survey of Pretreatment HIV Drug Resistance and Genetic Transmission Network Analysis Among HIV Patients in a High Drug-Use Area of Southwest China

Survey of Pretreatment HIV Drug Resistance and Genetic Transmission Network Analysis Among HIV Patients in a High Drug-Use Area of Southwest China

Comparative Circulation Dynamics of the Five Main HIV Types in China

The origin and spread of CRF85_BC, driven by heterosexual transmission among older people in Sichuan, China

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