A Comprehensive Mapping of HIV-1 Genotypes in Various Risk Groups and Regions across China Based on a Nationwide Molecular Epidemiologic Survey

BackgroundChina is experiencing a dynamic HIV/AIDS epidemic. While serology based surveillance systems have reported the spread of HIV/AIDS, detailed tracking of its transmission in populations and regions is not possible without mapping it at the molecular level. We therefore conducted a nationwide molecular epidemiology survey across the country.
MethodsHIV-1 genotypes were determined from 1,408 HIV-positive persons newly diagnosed in 2006. The prevalence of each genotype was estimated by weighting the genotype’s prevalence from each province- and risk-specific subpopulation with the number of reported cases in the corresponding subgroups in that year.
ResultsCRF07_BC (35.5%), CRF01_AE (27.6%), CRF08_BC (20.1%), and subtype B' (9.6%) were the four main HIV-1 strains in China. CRF07_BC and CRF08_BC were the primary drivers of infection among injecting drug users in northeastern and southeastern China, respectively, and subtype B' remained dominant among former plasma donors in central China. In contrast, all four strains occurred in significant proportions among heterosexuals nationwide, pointing to an expansion of the HIV-1 epidemic from high-risk populations into the general population. CRF01_AE also replaced subtype B as the principal driver of infection among men-who-have-sex-with-men.
ConclusionsOur study provides the first comprehensive baseline data on the diversity and characteristics of HIV/AIDS epidemic in China, reflecting unique region- and risk group-specific transmission dynamics. The results provide information critical for designing effective prevention measures against HIV transmission.

研究背景：我国正处于艾滋病（HIV/AIDS）的动态流行阶段。基于血清学的监测系统虽已报告了HIV/AIDS的传播态势，但若无分子水平的分型图谱，便无法精准追踪其在不同人群与地区间的传播链条。因此，我们开展了全国性的分子流行病学调查。
研究方法：本研究对2006年新确诊的1408名HIV感染者开展了HIV-1基因分型检测。通过以各省份、不同风险亚组当年报告的病例数作为权重，对对应亚组的基因型流行率进行加权估算，最终得到各类基因型的总体流行情况。
研究结果：CRF07_BC（35.5%）、CRF01_AE（27.6%）、CRF08_BC（20.1%）以及B'亚型（9.6%）为我国当前主要的HIV-1流行毒株。其中CRF07_BC与CRF08_BC分别为我国东北地区、东南地区注射吸毒人群感染的主导毒株，而B'亚型仍是我国中部地区既往采浆者群体中的优势流行株。相较之下，全国范围内的异性性行为人群中均检出了这四类毒株，提示HIV-1的流行已从高危人群向普通人群扩散。此外，CRF01_AE已取代B亚型，成为男男性行为者（men-who-have-sex-with-men）群体中的主要感染毒株。
研究结论：本研究首次提供了我国HIV/AIDS流行态势的多样性与特征的全面基线数据，清晰展现了我国不同地区、不同风险人群特有的传播动力学特征。本研究结果可为制定针对性的艾滋病传播预防措施提供关键科学依据。