Nationwide Trends in Molecular Epidemiology of HIV-1 in China

Abstract

To estimate the nationwide and regional distribution of HIV-1 genotypes in China in the past three decades, province-specific HIV-1 molecular epidemiology data were derived from 260 independent studies of HIV molecular prevalence through searching PubMed, VIP Chinese Journal Database (VIP), China National Knowledge Infrastructure, and Wanfang Data from January 1981 to December 2015. The nationwide and regional distribution of HIV-1 genotypes was estimated by weighting the genotype distribution from each province- and risk-specific subpopulation with the number of reported cases in the corresponding subgroups in the relevant periods. A sharp transition of HIV-1 subtypes and recombinant distribution was observed in various risk groups and regions over time. CRF01_AE has rapidly surged among almost all risk groups and in all areas, and it has become dominant among men who have sex with men and heterosexuals. A wide variety of new circulating recombinant forms (CRFs) and unique recombinant forms (URFs) were rapidly appearing in several risk groups and regions. After 2007, CRF01_AE was the most prevalent strain, accounting for 42.5% of all national infections, followed by CRF07_BC (28.9%), subtype B'/B (10.9%), CRF08_BC (10.0%), and subtype C (2.8%). URFs and other CRFs were responsible for 2.6% and fewer than 1% of infections nationwide, respectively. The nationwide and regional distributions of HIV-1 subtypes and recombinants were sharply shifting in China. CRF01_AE and new CRFs played an increasing role in the nationwide or regional HIV pandemic. The nationwide diversity of HIV-1 poses a formidable challenge to HIV vaccine development and disease prevention.

Histidine 375 Modulates CD4 Binding in HIV-1 CRF01_AE Envelope Glycoproteins

“…highest prevalence (18,36,37). Why this lineage of viruses was able to spread so rapidly is unclear at the moment; it did not spread particularly rapidly in Africa (14).…”

“…CRF01 was originally established in central Africa, where it had undergone diversification by the time the Asian CRF01 epidemic began in the late 1980s in Thailand (14,15). During the past decade, an increasing prevalence of the CRF01_AE subtype was observed, and it accounted for 42.5% of all national infections in China in 2007 (18) and 95% of those in Thailand in 2004 (19). CRF01_AE has a mosaic genome composed of the gag-pol region, most of the accessory genes from clade A, and the env gene from clade E (20).…”

Genetic transmission networks reveal the transmission patterns of HIV-1 CRF01_AE in China

“…This suggests that the impact of risk behaviours on HIV-1 transmission was greater than that of geographical locations. Thus, more benefits may be achieved from taking measures focused on curbing risk behaviours than regionally focused approaches 2. On a separate note, although lineage 1 was only mainly located in eastern China, both genetic transmission network and BSP analysis showed that it was still in a rapidly growing period.…”

Influence of the Envelope gp120 Phe 43 Cavity on HIV-1 Sensitivity to Antibody-Dependent Cell-Mediated Cytotoxicity Responses

“…Since the first emergence of CRF01_AE HIV-1 strains in Africa and subsequent spread to Asia, where it established a major epidemic, this virus has become the dominant strain in many Asian countries, including southern China and Thailand (48)(49)(50). Why CRF01_AE HIV-1 was able to spread so rapidly is unclear at the moment, but high viral loads and short survival times have been associated with CRF01_AE infection compared with the values seen for HIV-1 infections in the Western world (51)(52)(53).…”