title: Risk group characteristics and viral transmission clusters in South-East Asian patients infected with human immunodeficiency virus-1 (HIV-1) circulating recombinant form (CRF) 01_AE and subtype B.
abstract: Human immunodeficiency virus (HIV)-1 epidemics in Asian countries are driven by varying exposures. The epidemiology of the regional pandemic has been changing with the spread of HIV-1 to lower-risk populations through sexual transmission. Common HIV-1 genotypes include subtype B and circulating recombinant form (CRF) 01_AE. Our objective was to use HIV-1 genotypic data to better quantify local epidemics. TASER-M is a multicenter prospective cohort of HIV-infected patients. Associations between HIV exposure, patient sex, country of sample origin and HIV-1 genotype were evaluated by multivariate logistic regression. Phylogenetic methods were used on genotypic data to investigate transmission relationships. A total of 1086 patients from Thailand, Hong Kong, Malaysia and the Philippines were included in analyses. Proportions of male patients within countries varied (Thailand: 55.6%, Hong Kong: 86.1%, Malaysia: 81.4%, Philippines: 93.8%; p < 0.001) as did HIV exposures (heterosexual contact: Thailand: 85.7%, Hong Kong, 46.2%, Malaysia: 47.8%, Philippines: 25.0%; p < 0.001). After adjustment, we found increased subtype B infection among men who have sex with men, relative to heterosexual-reported exposures (odds ratio = 2.4, p < 0.001). We further describe four transmission clusters of eight to 15 treatment naïve, predominantly symptomatic patients (two each for subtype B and CRF01_AE). Risk-group subpopulations differed with respect to the infecting HIV-1 genotype. Homosexual exposure patients had higher odds of being infected with subtype B. Where HIV-1 genotypes circulate within countries or patient risk-groups, local monitoring of genotype-specific transmissions may play a role in focusing public health prevention strategies. Phylogenetic evaluations provide complementary information for surveillance and monitoring of viruses with high mutation rates such as HIV-1 and Ebola.
authors.affiliation: The Kirby Institute, University of New South Wales, Sydney, Australia.
authors.forename: Rebecca A
authors.initials: RA
authors.lastname: Oyomopito
authors.affiliation: Center for Infectious Disease and Cancer Research, Kaohsiung Medical University, Kaohsiung City, Taiwan.
authors.forename: Yen-Ju
authors.initials: YJ
authors.lastname: Chen
authors.affiliation: Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
authors.forename: Somnuek
authors.initials: S
authors.lastname: Sungkanuparph
authors.affiliation: Division of Infectious Diseases, Brown University Alpert Medical School, RI, USA.
authors.forename: Rami
authors.initials: R
authors.lastname: Kantor
authors.affiliation: Faculty of Medicine Udayana University & Sanglah Hospital, Bali, Indonesia.
authors.forename: Tuti
authors.initials: T
authors.lastname: Merati
authors.affiliation: Department of Microbiology, Queen Mary Hospital, Faculty of Medicine, The University of Hong Kong, Hong Kong, China.
authors.forename: Wing-Cheong
authors.initials: WC
authors.lastname: Yam
authors.affiliation: Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand.
authors.forename: Thira
authors.initials: T
authors.lastname: Sirisanthana
authors.affiliation: Department of Microbiology, Queen Mary Hospital, Faculty of Medicine, The University of Hong Kong, Hong Kong, China.
authors.forename: Patrick C K
authors.initials: PC
authors.lastname: Li
authors.affiliation: Chiangrai Prachanukroh Hospital, Chiangrai, Thailand.
authors.forename: Pacharee
authors.initials: P
authors.lastname: Kantipong
authors.affiliation: HIV-NAT/Thai Red Cross AIDS Research Centre, Bangkok, Thailand.
authors.forename: Praphan
authors.initials: P
authors.lastname: Phanuphak
authors.affiliation: Hospital Sungai Buloh, Sungai Buloh, Malaysia.
authors.forename: Chris K C
authors.initials: CK
authors.lastname: Lee
authors.affiliation: University Malaya Medical Centre, Kuala Lumpur, Malaysia.
authors.forename: Adeeba
authors.initials: A
authors.lastname: Kamarulzaman
authors.affiliation: Research Institute for Tropical Medicine, Manila, Philippines.
authors.forename: Rossana
authors.initials: R
authors.lastname: Ditangco
authors.affiliation: Center for Infectious Disease and Cancer Research, Kaohsiung Medical University, Kaohsiung City, Taiwan.
authors.forename: Szu-Wei
authors.initials: SW
authors.lastname: Huang
authors.affiliation: TREAT Asia, amfAR-The Foundation for AIDS Research, Bangkok, Thailand.
authors.forename: Annette H
authors.initials: AH
authors.lastname: Sohn
authors.affiliation: The Kirby Institute, University of New South Wales, Sydney, Australia.
authors.forename: Matthew
authors.initials: M
authors.lastname: Law
authors.affiliation: Center for Infectious Disease and Cancer Research, Kaohsiung Medical University, Kaohsiung City, Taiwan; Department of Microbiology, Kaohsiung Medical University, Kaohsiung City, Taiwan. Electronic address: arthur@kmu.edu.tw.
authors.forename: Yi Ming A
authors.initials: YM
authors.lastname: Chen
mesh_terms: D000328:Adult; D001210:Asia, Southeastern / Q000453:epidemiology; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000635:transmission* / Q000821:virology*; D015497:HIV-1 / Q000502:physiology*; D006801:Humans; D008297:Male; D010802:Phylogeny; D012307:Risk Factors
keywords: Asia; CRF01_AE; HIV exposure; Subtype B