HIV-1 subtype diversity and transmission strain source among men who have sex with men in Guangxi, China

Abstract

With the rapid increase in HIV prevalence of men who have sex with men (MSM) in recent years and common human migration and travelling across different provinces in China, MSM are now finding it easier to meet each other, which might contribute to local HIV epidemics as well as fueling cross-province transmission. We performed a cross-sectional survey in 2018-2019 to investigate the current HIV subtype diversity and inferred HIV strain transmission origin among MSM in Guangxi province, China based on a phylogenetic analysis. Based on 238 samples, we found that the HIV-1 subtype diversity was more complicated than before, except for three major HIV subtypes/circulating recombinant forms (CRFs): CRF07_BC, CRF01_AE, CRF55_01B, five other subtypes/CRFs (CRF59_01B, B, CRF08_BC, CRF67_01B, CRF68_01B) and five unique recombinant forms (URFs) were detected. In total, 76.8% (169/220) of samples were infected with HIV from local circulating strains, while others originated from other provinces, predominantly Guangdong and Shanghai. The high diversity of HIV recombinants and complicated HIV transmission sources in Guangxi MSM indicates that there has been an active sexual network between HIV positive MSM both within and outside Guangxi without any effective prevention. Inter-province collaboration must be enforced to provide tailored HIV prevention and control services to MSM in China.

Figure 1

Maximum-likelihood phylogenetic trees of HIV-1 pol sequences from 238 MSM in Nanning, Guangxi, China. The topology of trees was tested by IQ Tree (V.2.0.6)ultrafast bootstrap (UFBoot) approximation with 1000 bootstrap replicates, the bootstrap values were showed on the corresponding nodes, Clusters with bootstrap value ≧0.95 (95%) were defined as phylogenetic cluster. Red clade denoted reference sequence, black clade denoted samples sequences and blue clade represented URF.