Genetic and epidemiologic characterization of HIV-1 infection In Liaoning Province, China.
BACKGROUND
Although many studies of HIV-1 in China have focused on high-risk injecting drug users and former blood donors in high prevalence regions, little is known about HIV-1 in relatively low prevalence provinces. Here, we compare the epidemiologic and genetic profile of HIV-1 in Liaoning-a low prevalence province-with those identified in China's most severely affected provinces.


METHODS
Two hundred eight HIV-1-positive subjects from all major cities in Liaoning province were recruited between 2000 and 2008. 2.6 kilobase gag-pol sequences were amplified from plasma viral RNA and sequenced directly. The HIV-1 sequences obtained were analyzed using phylogenetic and recombinant approaches.


RESULTS
We have shown that in recent years, although HIV-1 prevalence in Liaoning has remained low, the rate of new infection has increased rapidly, particularly among men who have sex with men and heterosexual risk individuals (together comprising >54% of infected individuals in 2007). Furthermore, phylogenetic analysis has identified all major subtypes/circulating recombinant forms of HIV-1 in Liaoning previously identified in high prevalence provinces. Our study also shows close relationships between HIV-1 subtype/circulating recombinant form and certain risk behaviors. Notably, men who have sex with men and heterosexual risk individuals harbor most divergent strains of HIV-1 from multiple high-risk groups.


CONCLUSIONS
Our study suggested that HIV-1 continues to spread to the general population through sexual contact; Liaoning, therefore, serves as the critical base for the introduction and spread of HIV-1 in northeast China. We believe the transmission patterns suggested herein will help guide public health workers in reducing further spread of HIV-1 within China.
Han
Xiaoxu
X
Hospital of China Medical University, Shenyang, China.
Dai
Di
D
Zhao
Bin
B
Liu
Jing
J
Ding
Haibo
H
Zhang
Min
M
Hu
Qinghai
Q
Lu
Chunming
C
Goldin
Mark
M
Takebe
Yutaka
Y
Zhang
Linqi
L
Shang
Hong
H
D000293:Adolescent; D000328:Adult; D002681:China / Q000453:epidemiology; D005260:Female; D014644:Genetic Variation; D015658:HIV Infections / Q000453:epidemiology* / Q000821:virology*; D015497:HIV-1 / Q000145:classification / Q000235:genetics*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010802:Phylogeny; D012367:RNA, Viral / Q000235:genetics; D012307:Risk Factors; D013997:Time Factors; D055815:Young Adult
D012367:RNA, Viral