The rapidly expanding CRF01_AE epidemic in China is driven by multiple lineages of HIV-1 viruses introduced in the 1990s

Abstract

Objectives:We sought to comprehensively analyze the origin, transmission patterns and sub-epidemic clusters of the HIV-1 CRF01_AE strains in China.Methods:Available HIV-1 CRF01_AE samples indentified in national molecular epidemiologic surveys were used to generate near full-length genome (NFLG) sequences. The new and globally available CRF01_AE NFLG sequences were subjected to phylogenetic and Bayesian molecular clock analyses, and combined with epidemiologic data to elucidate the history of CRF01_AE transmission in China.Results:We generated 75 new CRF01_AE NFLG sequences from various risk populations covering all major CRF01_AE epidemic regions in China. Seven distinct phylogenetic clusters of CRF01_AE were identified. Clusters 1, 2 and 3 were prevalent among heterosexuals and IDUs in southern and southwestern provinces. Clusters 4 and 5 were found primarily among MSM in major northern cities. Clusters 6 and 7 were only detected among heterosexuals in two southeast and southwest provinces. Molecular clock analysis indicated that all CRF01_AE clusters were introduced from Southeast Asia in the 1990s, coinciding with the peak of Thailand's HIV epidemic and the initiation of China's free overseas travel policy for their citizens, which started with Thailand as the first destination country.Conclusion:China's HIV-1 epidemic of sexual transmissions, was initiated by multilineages of CRF01_AE strains, in contrast to the mono-lineage epidemic of B′ strain in former plasma donors and IDUs. Our study underscores the difficulty in controlling HIV-1 sexual transmission compared with parenteral transmission.

HIV Epidemic in Asia: Implications for HIV Vaccine and Other Prevention Trials

“…Recently, however, MSM is the risk group associated with the most rapid increases in HIV infections within China, and studies note HIV-1 strains of different subtypes and CRFs. [38][39][40][41][42] In cities in northern China CRF01_AE infection in MSM is more common than subtype B, 24,[43][44][45] with similar trends in Beijing, Fujian, Guizho, Guandong, Guanxi, Hebei, Hong Kong, Hunan, Jiangsu, Jianxi, Shanghai, and Yunnan. CRF07_BC has recently been identified in young MSM and in some cities exceeds the prevalence of CRF01_AE infection (unpublished data).…”

Near Full-Length Genome Identification of a Novel HIV-1 Recombinant Form (CRF01_AE/B′/C) Among Heterosexuals in Jilin, China

“…3). 8 Therefore, taking the data together, it is tempting to hypothesize that the novel recombinant form (CRF01_AE/B¢/ C) of HIV-1 was more likely a cross-region (preferable JilinYunnan), even cross-border (probably China-Myanmar) transmission event, and less likely a local HIV-1 recombinant form generated among heterosexuals in Jilin province of northeastern China. The recombinant map results revealed that the subtype B¢ (II, IV, and VII) and C (III, VI, and VIII) regions were located in the gag and pol gene regions, a unique mosaic structure distinct form CRF01_AE/B¢/C recombinant isolates of HIV-1 previously reported (Fig.…”

Determinants and Status of HIV Disclosure among Reproductive Age Women on Antiretroviral Therapy at Three Health Facilities in Jimma Town, Ethiopia, 2017

“…The trends in new HIV infections has inflated from 23 000 in 2010 to 30,000 in 2016 in Ethiopia [3]. There is large prevalence difference among districts (6.6% in Gambella, 5.0% in Addis Ababa, and 0.7% in Southern Nations, Nationalities and Peoples' region).…”