title: Genetic Characteristics of CRF01_AE Among Newly Diagnosed HIV-1-Infected 16- to 25-Year Olds in 3 Geographic Regions of Guangxi, China.
abstract: The aim of this study was to analyze the distribution of clusters and drug resistance of CRF01_AE among newly diagnosed, treatment-naïve HIV-infected teenagers and young adults in 3 major HIV-affected geographic regions of Guangxi Province, including the cities of Hezhou, Liuzhou, and Nanning. Samples were sequentially collected from newly diagnosed HIV-infected 16- to 25-year olds in these 3 regions from 2009 to 2013. The viral genome was extracted, and the partial pol gene was amplified and sequenced. Phylogenetic analyses were used to determine HIV-1 subtypes and CRF01_AE clusters. Transmitted drug resistance (TDR) mutations were identified using the 2009 WHO list of TDR mutations. A total of 216 sequences were obtained from CRF01_AE strains, which accounted for 83.1% of the 260 genotyped samples, of which 36 were from Hezhou, 147 from Liuzhou, and 33 in Nanning. Most (83.3%, 180/216) were from heterosexuals, followed by injection drug users (5.6%), homosexuals (4.2%), and unknown risk group (6.9%). Based on phylogenetic analyses by the maximum likelihood method, 5 distinct clusters (cluster 1-5) were identified with 213 (98.6%) sequences, whereas 3 (1.4%) sequences were ungrouped. In Hezhou, 88.9% (32/36) of CRF01_AE infections were caused by cluster 2, and 11.1% (4/36) were caused by cluster 1. In Liuzhou, 83.0% (122/147) of the CRF01_AE strains were found in cluster 1, 11.6% (17/147) from cluster 2, 1.4% (2/147) from cluster 3, 2.7% (4/147) from cluster 4, and 0.7% (1/147) from cluster 5. The distribution of CRF01_AE clusters was more even in Nanning than it was in the other 2 regions, with 18.2% (6/33) from cluster 1, 36.3% (12/33) from cluster 2, 9.1% (3/33) from cluster 3, 18.2% (6/33) from cluster 4, and 12.1% (4/33) from cluster 5. The most frequent TDR mutations were M46I (2) in the protease region and Y181C (2) from the reverse transcriptase fragment. Clusters 1 and 2 of CRF01_AE strains were prevalent in Liuzhou and Hezhou, respectively. However, multiple CRF01_AE clusters existed in Nanning. This can be partially explained by the high mobility of laborers in Nanning, the capital city of Guangxi. The prevalence of TDR was low.
authors.affiliation: From the State Key Laboratory for Infectious Disease Prevention and Control, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Beijing (JZ, ZL, CH, YF, Y-HR, Y-MS, HX, L-JL); and Guangxi Center for Disease Prevention and Control, Nanning, Guangxi Province, China(Z-YS, S-JL, F-XL, J-JL, Y-JZ).
authors.forename: Jing
authors.initials: J
authors.lastname: Zhang
authors.forename: Zhi-Yong
authors.initials: ZY
authors.lastname: Shen
authors.forename: Zheng
authors.initials: Z
authors.lastname: Li
authors.forename: Shu-Jia
authors.initials: SJ
authors.lastname: Liang
authors.forename: Cui
authors.initials: C
authors.lastname: He
authors.forename: Fu-Xiong
authors.initials: FX
authors.lastname: Liang
authors.forename: Yi
authors.initials: Y
authors.lastname: Feng
authors.forename: Jian-Jun
authors.initials: JJ
authors.lastname: Li
authors.forename: Yu-Hua
authors.initials: YH
authors.lastname: Ruan
authors.forename: Yue-Jiao
authors.initials: YJ
authors.lastname: Zhou
authors.forename: Yi-Ming
authors.initials: YM
authors.lastname: Shao
authors.forename: Hui
authors.initials: H
authors.lastname: Xing
authors.forename: Ling-Jie
authors.initials: LJ
authors.lastname: Liao
mesh_terms: D000293:Adolescent; D000328:Adult; D002681:China / Q000453:epidemiology; D024882:Drug Resistance, Viral; D055030:Drug Users; D005260:Female; D015751:Genes, pol / Q000235:genetics*; D016679:Genome, Viral; D005838:Genotype; D015658:HIV Infections / Q000453:epidemiology* / Q000235:genetics*; D015497:HIV-1 / Q000235:genetics*; D006801:Humans; D016013:Likelihood Functions; D008297:Male; D008969:Molecular Sequence Data; D016133:Polymerase Chain Reaction; D015995:Prevalence; D019529:Sexuality; D015819:Substance Abuse, Intravenous / Q000453:epidemiology; D055815:Young Adult