Objectives The epidemic of HIV-1 CRF01_AE has become a major public health issue in China. This study aimed to characterise the transmission patterns of genetic networks for CRF01_AE nationwide and elucidate possible opportunities for prevention.
Methods We isolated and conducted genetic transmission network analysis of all available CRF01_AE pol sequences (n=4704) from China in the Los Alamos HIV sequence database.
Results A total of 1391 (29.6%) sequences were identified as belonging to 400 separate networks. Of men who have sex with men (MSM) in the networks, 93.8% were linked to other MSM and only 2.4% were linked to heterosexual women. However, 11.8% heterosexual women in the networks were linked to MSM. Lineages composed mainly of MSM had higher transmission than those that were mostly heterosexuals. Of the 1391 individuals in networks, 513 (36.9%) were linked to cases diagnosed in different provinces. The proportion of individuals involved in inter-province links was interrelated with the number of migrant people (Spearman's r=0.738, p=0.001).
Conclusions The outcome of this study could help improve our ability to understand HIV transmission among various regions and risk groups in China, and highlighted the importance of targeting MSM and migrants by prevention and intervention efforts.
- MOLECULAR EPIDEMIOLOGY
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Handling editor Jackie A Cassell
Contributors XL, PZ and PW conceived and designed the study. XL, RG, KZ, KF, FW, WL, YS, YG and YJ prepared the data. XL, RG and KZ analysed the data. XL, RG, KZ, PZ and PW wrote the paper. All authors read and approved the final manuscript.
Funding This work was supported by the Fundamental Research Funds for the Central Universities and Research Innovation Program for College Graduates of Jiangsu Province (KYLX15_0173) and the Humanities and Social Sciences of Ministry of Education Planning Fund of China (no. 16YJA840014).
Disclaimer The funders had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript.
Competing interests None declared.
Ethics approval Review committee number 2017ZDKYSB045.
Provenance and peer review Not commissioned; externally peer reviewed.