title: Nationwide Trends in Molecular Epidemiology of HIV-1 in China.
abstract: To estimate the nationwide and regional distribution of HIV-1 genotypes in China in the past three decades, province-specific HIV-1 molecular epidemiology data were derived from 260 independent studies of HIV molecular prevalence through searching PubMed, VIP Chinese Journal Database (VIP), China National Knowledge Infrastructure, and Wanfang Data from January 1981 to December 2015. The nationwide and regional distribution of HIV-1 genotypes was estimated by weighting the genotype distribution from each province- and risk-specific subpopulation with the number of reported cases in the corresponding subgroups in the relevant periods. A sharp transition of HIV-1 subtypes and recombinant distribution was observed in various risk groups and regions over time. CRF01_AE has rapidly surged among almost all risk groups and in all areas, and it has become dominant among men who have sex with men and heterosexuals. A wide variety of new circulating recombinant forms (CRFs) and unique recombinant forms (URFs) were rapidly appearing in several risk groups and regions. After 2007, CRF01_AE was the most prevalent strain, accounting for 42.5% of all national infections, followed by CRF07_BC (28.9%), subtype B'/B (10.9%), CRF08_BC (10.0%), and subtype C (2.8%). URFs and other CRFs were responsible for 2.6% and fewer than 1% of infections nationwide, respectively. The nationwide and regional distributions of HIV-1 subtypes and recombinants were sharply shifting in China. CRF01_AE and new CRFs played an increasing role in the nationwide or regional HIV pandemic. The nationwide diversity of HIV-1 poses a formidable challenge to HIV vaccine development and disease prevention.
authors.affiliation: 1 Teaching and Research Office of Epidemiology and Health Statistics, School of Public Health, Southeast University , Nanjing, China .
authors.forename: Xiaoshan
authors.initials: X
authors.lastname: Li
authors.affiliation: 2 Department of Infectious Disease Prevention and School Health, Nanjing Municipal Center for Disease Control and Prevention , Nanjing, China .
authors.forename: Wei
authors.initials: W
authors.lastname: Li
authors.affiliation: 3 Department of 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
authors.affiliation: 1 Teaching and Research Office of Epidemiology and Health Statistics, School of Public Health, Southeast University , Nanjing, China .
authors.forename: Kun
authors.initials: K
authors.lastname: Fang
authors.affiliation: 4 School of Public Health, Nantong University , Nantong, China .
authors.forename: Kexin
authors.initials: K
authors.lastname: Zhu
authors.affiliation: 1 Teaching and Research Office of Epidemiology and Health Statistics, School of Public Health, Southeast University , Nanjing, China .
authors.forename: Taha Hussein
authors.initials: TH
authors.lastname: Musa
authors.affiliation: 1 Teaching and Research Office of Epidemiology and Health Statistics, School of Public Health, Southeast University , Nanjing, China .
authors.forename: Yue
authors.initials: Y
authors.lastname: Song
authors.affiliation: 1 Teaching and Research Office of Epidemiology and Health Statistics, School of Public Health, Southeast University , Nanjing, China .
authors.forename: Guoping
authors.initials: G
authors.lastname: Du
authors.affiliation: 1 Teaching and Research Office of Epidemiology and Health Statistics, School of Public Health, Southeast University , Nanjing, China .
authors.forename: Rong
authors.initials: R
authors.lastname: Gao
authors.affiliation: 1 Teaching and Research Office of Epidemiology and Health Statistics, School of Public Health, Southeast University , Nanjing, China .
authors.forename: Yan
authors.initials: Y
authors.lastname: Guo
authors.affiliation: 1 Teaching and Research Office of Epidemiology and Health Statistics, School of Public Health, Southeast University , Nanjing, China .
authors.forename: Wenjuan
authors.initials: W
authors.lastname: Yan
authors.affiliation: 1 Teaching and Research Office of Epidemiology and Health Statistics, School of Public Health, Southeast University , Nanjing, China .
authors.forename: Yang
authors.initials: Y
authors.lastname: Xuan
authors.affiliation: 1 Teaching and Research Office of Epidemiology and Health Statistics, School of Public Health, Southeast University , Nanjing, China .
authors.forename: Pingmin
authors.initials: P
authors.lastname: Wei
mesh_terms: D002681:China / Q000453:epidemiology; D014644:Genetic Variation; D005838:Genotype; D015658:HIV Infections / Q000453:epidemiology* / Q000821:virology*; D015497:HIV-1 / Q000145:classification* / Q000235:genetics* / Q000302:isolation & purification; D006801:Humans; D017720:Molecular Epidemiology; D015995:Prevalence