Distinct Rates and Transmission Patterns of Major HIV-1 Subtypes among Men who Have Sex with Men in Guangxi, China

Drug resistance and genetic transmission characteristics of HIV-1 CRF55_01B in people living with HIV/AIDS (PLWHA) in Henan Province, China

BACKGROUND

Among the many CRFs, CRF55_01B was the first CRF01_AE and subtype B recombinant strain identified around 2013 among men who have sex with men (MSM) in Shenzhen, China. With rapid spreading throughout the country, CRF55_01B has attracted much attention in recent years. This study aimed to analyze its prevalence of drug resistance and transmission characteristics in people living with HIV/AIDS (PLWHA) in Henan province, China so as to pay particular attention to this group of individuals to reduce the incidence of drug resistance.

RESULTS

Two hundred and forty-five CRF55_01B-infected individuals, including 141 treatment-naïve and 104 treatment-experienced individuals, were enrolled. In treatment-naïve individuals, 6.38% (9/141) of them harboured NRTI DRMs and 19.15% (27/141) of them harboured NNRTI DRMs except V179E/D. In treatment-experienced individuals, 2.00% (2/100) harboured INSTI DRMs, 82.69% (86/104) of them harboured NRTI DRMs, and 88.46% (92/104) of them harboured NNRTI DRMs except V179E/D. The overall prevalence of ADR was 89.42% (93/104), while the prevalence of PDR was 19.86% (28/141). A total of 23 transmission clusters, accounting for 37.55% (92/245) of the total sequences, were identified. The clusters ranged in size from 2 to 19, and 15 (65.22%) had 3 or more sequences.

CONCLUSIONS

High prevalence of DRMs and drug resistance were observed in CRF55_01B in both treatment-naïve and treatment-experienced individuals, particular attention should be paid to this group of individuals to reduce the incidence of drug resistance.

The changing molecular epidemiology of HIV-1 in Liangshan prefecture, China, in 2021-2023

Introduction

Liangshan Prefecture is one of the areas in China most severely affected by human immunodeficiency virus (HIV), but little is known about the molecular epidemiology of HIV-1 in this area. We aimed to analyze the distribution of HIV-1 genetic variants in Liangshan Prefecture in recent years.

Methods

8,523 blood samples were collected from people living with HIV with treatment failure and newly diagnosed individuals in all 17 counties and cities in Liangshan Prefecture between 2021 and 2023.

Results

The majority of study participants were male (66%), farmers (78%) and illiterate (53%). The main HIV-1 transmission routes were heterosexual contact (57%) and injecting drug use (27%). Among the 6,298 successfully obtained pol sequences the following HIV-1 variants were identified: CRF07_BC (93.9%), CRF08_BC (3.3%), CRF01_AE (1.4%), URFs (0.9%), CRF105_0108 (0.1%), CRF55_01B (0.1%), subtype B (0.1%), subtype C (0.1%), CRF88_BC (0.1%), CRF83_cpx (0.1%), CRF85_BC (0.03%), CRF67_01B (0.02%), CRF77_cpx (0.02%), and subtype A (0.02%). During the study period, the proportion of CRF07_BC gradually decreased, while other HIV-1 variants increased, a shift seen across all counties in Liangshan Prefecture. Newly diagnosed patients mainly acquired HIV through heterosexual transmission (86.7%), had a lower proportion of CRF07_BC (90.9%) and higher proportion of other HIV-1 variants, compared to treatment failure patients.

Conclusion

Future prevention and control policies need to take these changes into account.

A Spatiotemporal Analysis of a High-Resolution Molecular Network Reveals Shifts of HIV-1 Transmission Hotspots in Guangzhou, China

BACKGROUND

High-resolution and longitudinal HIV molecular surveillance can inform the evolving hotspots to tailor regionally focused control strategies.

METHODS

HIV-1 pol sequences of three predominant genotypes (CRF01_AE, CRF07_BC, and CRF55_01B) were collected for molecular network reconstruction from people living with HIV (PLWH) in Guangzhou (2018-2020). They were categorized by geographical residences into central, suburban, and outer suburban areas. Clustering rates, assortativity coefficients, and intensity matrices were employed to assess transmission dynamics, geographic mixing patterns, and intra- and inter-area transmission, respectively.

RESULTS

Of the 2469 PLWH, 55.5% resided in the central area. Clustering rates showed no significant differences across areas (44.5%, 40.6% vs. 45.7%; p = 0.184). However, the transmission hotspots for CRF01_AE and CRF55_01B shifted to the outer suburban area. PLWH tended to form links within their local area (assortativity coefficient = 0.227, p < 0.001), particularly for CRF01_AE (0.512, p < 0.001; intra-area intensity = 69.2%). The central area exhibited the highest but decreasing intra-area transmission (74.5% to 30.2%), while intra- and inter-area transmission involving the outer suburban area increased (23.1% to 38.2%).

CONCLUSIONS

Despite most PLWH residing in the central area, the outer suburban area emerged as the hotspot, requiring interventions towards both intra- and inter-area transmission.