Molecular epidemiological tracing of HIV-1 outbreaks in Hainan island of southern China.
OBJECTIVE
To determine the prevalence of HIV in Hainan island and the molecular epidemiological linkages related to risk factors of viral transmission.


METHODS
A governmental HIV/AIDS surveillance program, HIV serological study was conducted in volunteers from several high-risk groups between 1991 and 2006 in Hainan province. By phylogenetic reconstruction, we performed a molecular epidemiological tracing in a representative subset of the HIV-1-seropositive individuals diagnosed during this survey.


RESULTS
Of 499 752 volunteers, 523 (0.1%) accumulated cases of HIV-1 infection (69.2% needle-sharing drug users, 19.3% heterosexually acquired adults, 3.3% receivers of blood transfusion, 0.8% children born from HIV-1-infected mothers, and 7.7% remained unknown) were diagnosed. Among 83 patient samples examined (70 were infected with HIV-1 subtypes CRF01_AE and eight, two, one, one, and one were B', C, CRF08_BC, B, and a new CRF01_AE/B' recombinant, respectively), 66 (79.5%) were segregated into one large cluster (59 sequences) (founder effect) and one small cluster (three sequences) of CRF01_AE, one small cluster (two sequences) of B', and one small cluster (two sequences) of C. Phylogenetic and epidemiological linkages confirmed four heterosexual transmission events and rejected two potential heterosexual transmission suggested by contact tracing. Only two cases of CRF01_AE showed mutations conferring resistance to nucleoside and nonnucleoside reverse transcriptase inhibitors.


CONCLUSIONS
The reconstruction of current HIV-1 outbreaks by molecular epidemiological tracing is helpful for identifying epidemic sources and for defining prevention strategies.
Deng
Wei
W
Sino-French Collaboration Center for AIDS Research, Chinese Academy of Medical Sciences and Peking Union Medical College, Tsinghua University, Beijing, People's Republic of China.
Fu
Peng
P
Bao
Linlin
L
Vidal
Nicole
N
He
Qiya
Q
Qin
Chuan
C
Peeters
Martine
M
Delaporte
Eric
E
Andrieu
Jean-Marie
JM
Lu
Wei
W
D000328:Adult; D001483:Base Sequence; D001803:Blood Transfusion; D002681:China / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000635:transmission; D015497:HIV-1 / Q000145:classification / Q000235:genetics*; D020010:Heterosexuality; D006801:Humans; D018445:Infectious Disease Transmission, Vertical; D008297:Male; D008875:Middle Aged; D008969:Molecular Sequence Data; D016485:Needle Sharing; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000453:epidemiology / Q000235:genetics / Q000821:virology; D015995:Prevalence; D012367:RNA, Viral / Q000235:genetics; D012307:Risk Factors; D018571:Sentinel Surveillance; D015819:Substance Abuse, Intravenous / Q000453:epidemiology; D054299:env Gene Products, Human Immunodeficiency Virus / Q000235:genetics; D054302:pol Gene Products, Human Immunodeficiency Virus / Q000235:genetics
D012367:RNA, Viral; D054299:env Gene Products, Human Immunodeficiency Virus; D054302:pol Gene Products, Human Immunodeficiency Virus