title: HIV-1 Genetic Diversity and Its Impact on Baseline CD4+T Cells and Viral Loads among Recently Infected Men Who Have Sex with Men in Shanghai, China.
abstract: The HIV-1 epidemic among men who have sex with men (MSM) has been spreading throughout China. Shanghai, a central gathering place for MSM, is facing a continuously increasing incidence of HIV-1 infection. In order to better understand the dynamics of HIV-1 diversity and its influence on patient's immune status at baseline on diagnosis, 1265 newly HIV-1-infected MSM collected from January 2009 to December 2013 in Shanghai were retrospectively analyzed for genetic subtyping, CD4+T cell counts, and viral loads. HIV-1 phylogenetic analysis revealed a broad viral diversity including CRF01_AE (62.13%), CRF07_BC (24.51%), subtype B (8.06%), CRF55_01B (3.24%), CER67_01B (0.95%), CRF68_01B (0.4%), CRF08_BC (0.08%) and CRF59_01B (0.08%). Twenty-four unique recombination forms (URFs) (1.98%) were identified as well. Bayesian inference analysis indicated that the introduction of CRF01_AE strain (1997) was earlier than CRF07_BC strain (2001) into MSM population in Shanghai based on the time of the most recent common ancestor (tMRCA). Three epidemic clusters and five sub-clusters were found in CRF01_AE. Significantly lower CD4+T cell count was found in individuals infected with CRF01_AE than in those infected with CRF07_BC infection (P<0.01), whereas viral load was significantly higher those infected with CRF01_AE than with CRF07_BC (P<0.01). In addition, the patients with >45 years of age were found to have lower CD4+T cell counts and higher viral loads than the patients with <25 years of age (P<0.05). This study reveals the presence of HIV-1 subtype diversity in Shanghai and its remarkable influence on clinical outcome. A real-time surveillance of HIV-1 viral diversity and phylodynamics of epidemic cluster, patient's baseline CD4+T cell count and viral load would be of great value to monitoring of disease progression, intervention for transmission, improvement of antiretroviral therapy strategy and design of vaccines.
authors.affiliation: Department AIDS and STD, Shanghai Municipal Center for Disease Control and Prevention, Shanghai Municipal Institutes for Preventive Medicine, Shanghai, China; Public Health College, Nantong University, Nantong, Jiangsu Province, China.
authors.forename: Xiaoyan
authors.initials: X
authors.lastname: Li
authors.affiliation: Department AIDS and STD, Shanghai Municipal Center for Disease Control and Prevention, Shanghai Municipal Institutes for Preventive Medicine, Shanghai, China.
authors.forename: Yile
authors.initials: Y
authors.lastname: Xue
authors.affiliation: Department AIDS and STD, Shanghai Municipal Center for Disease Control and Prevention, Shanghai Municipal Institutes for Preventive Medicine, Shanghai, China.
authors.forename: Hua
authors.initials: H
authors.lastname: Cheng
authors.affiliation: Department AIDS and STD, Shanghai Municipal Center for Disease Control and Prevention, Shanghai Municipal Institutes for Preventive Medicine, Shanghai, China.
authors.forename: Yi
authors.initials: Y
authors.lastname: Lin
authors.affiliation: Department AIDS and STD, Shanghai Municipal Center for Disease Control and Prevention, Shanghai Municipal Institutes for Preventive Medicine, Shanghai, China.
authors.forename: Leiming
authors.initials: L
authors.lastname: Zhou
authors.affiliation: Department AIDS and STD, Shanghai Municipal Center for Disease Control and Prevention, Shanghai Municipal Institutes for Preventive Medicine, Shanghai, China.
authors.forename: Zhen
authors.initials: Z
authors.lastname: Ning
authors.affiliation: Department AIDS and STD, Shanghai Municipal Center for Disease Control and Prevention, Shanghai Municipal Institutes for Preventive Medicine, Shanghai, China.
authors.forename: Xuqin
authors.initials: X
authors.lastname: Wang
authors.affiliation: Department AIDS and STD, Shanghai Municipal Center for Disease Control and Prevention, Shanghai Municipal Institutes for Preventive Medicine, Shanghai, China.
authors.forename: Xiaolei
authors.initials: X
authors.lastname: Yu
authors.affiliation: Department AIDS and STD, Shanghai Municipal Center for Disease Control and Prevention, Shanghai Municipal Institutes for Preventive Medicine, Shanghai, China.
authors.forename: Wei
authors.initials: W
authors.lastname: Zhang
authors.affiliation: Department AIDS and STD, Shanghai Municipal Center for Disease Control and Prevention, Shanghai Municipal Institutes for Preventive Medicine, Shanghai, China.
authors.forename: Fangwei
authors.initials: F
authors.lastname: Shen
authors.affiliation: Department AIDS and STD, Shanghai Municipal Center for Disease Control and Prevention, Shanghai Municipal Institutes for Preventive Medicine, Shanghai, China.
authors.forename: Xiaohong
authors.initials: X
authors.lastname: Zheng
authors.affiliation: Department AIDS and STD, Shanghai Municipal Center for Disease Control and Prevention, Shanghai Municipal Institutes for Preventive Medicine, Shanghai, China.
authors.forename: Jing
authors.initials: J
authors.lastname: Gai
authors.affiliation: Public Health College, Nantong University, Nantong, Jiangsu Province, China.
authors.forename: Xiaoshan
authors.initials: X
authors.lastname: Li
authors.affiliation: Department AIDS and STD, Shanghai Municipal Center for Disease Control and Prevention, Shanghai Municipal Institutes for Preventive Medicine, Shanghai, China.
authors.forename: Laiyi
authors.initials: L
authors.lastname: Kang
authors.affiliation: Department of Pathology, New York University School of Medicine, New York, United States of America.
authors.forename: Phillipe
authors.initials: P
authors.lastname: Nyambi
authors.affiliation: Department AIDS and STD, Shanghai Municipal Center for Disease Control and Prevention, Shanghai Municipal Institutes for Preventive Medicine, Shanghai, China.
authors.forename: Ying
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department AIDS and STD, Shanghai Municipal Center for Disease Control and Prevention, Shanghai Municipal Institutes for Preventive Medicine, Shanghai, China.
authors.forename: Minghua
authors.initials: M
authors.lastname: Zhuang
authors.affiliation: Department AIDS and STD, Shanghai Municipal Center for Disease Control and Prevention, Shanghai Municipal Institutes for Preventive Medicine, Shanghai, China.
authors.forename: Qichao
authors.initials: Q
authors.lastname: Pan
authors.affiliation: Public Health College, Nantong University, Nantong, Jiangsu Province, China.
authors.forename: Xun
authors.initials: X
authors.lastname: Zhuang
authors.affiliation: Department AIDS and STD, Shanghai Municipal Center for Disease Control and Prevention, Shanghai Municipal Institutes for Preventive Medicine, Shanghai, China.
authors.forename: Ping
authors.initials: P
authors.lastname: Zhong
mesh_terms: D000328:Adult; D018791:CD4 Lymphocyte Count; D015496:CD4-Positive T-Lymphocytes / Q000276:immunology*; D002681:China / Q000453:epidemiology; D003710:Demography; D014644:Genetic Variation; D015658:HIV Infections / Q000453:epidemiology / Q000276:immunology* / Q000821:virology*; D015497:HIV-1 / Q000235:genetics*; D018451:Homosexuality, Male / Q000235:genetics*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010802:Phylogeny; D019562:Viral Load / Q000276:immunology*