Factors associated with needle sharing among people who inject drugs in Yunnan, China: a combined network and regression analysis

Characterization of a Novel HIV-1 Recombinant Form (CRF01_AE/CRF07_BC/CRF08_BC) Identified from Guangxi, China

Recently, more and more kinds of circulating recombinant forms (CRFs) and unique recombinant forms (URFs) were identified in the population in China. A novel HIV-1 recombinant virus (2016GXNNIDU016) was identified in this study, which was isolated from an HIV-1 infected intravenous drug user in Nanning, the capital of Guangxi, China. Phylogenetic analysis of the near full-length genome (NFLG) indicated that the sequence (2016GXNNIDU016) was a monophyletic branch that did not cluster with any previously identified genotype. Recombinant analysis showed that the NFLG of 2016GXNNIDU016 is composed of CRF07_BC, CRF01_AE, and CRF08_BC, including nine mosaic segments. Differing from previously documented CRF01_AE and CRF07/08_BC recombinant forms, 2016GXNNIDU016 increases the genetic complexity of HIV-1 in Guangxi. The constant emergence of novel recombinant forms should draw our attention to make more efforts in supervising and preventing the spread of HIV infection.

Burmese injecting drug users in Yunnan play a pivotal role in the cross-border transmission of HIV-1 in the China-Myanmar border region

Injecting drug users (IDUs) are the major risk group for HIV-1 infection in the China-Myanmar border area. There are a large number of Burmese IDUs living in Yunnan (Yunnan-mIDUs) who might be associated with the cross-border transmission of HIV-1. From 2010 to 2013, 617 Yunnan-mIDUs were recruited from three counties of Yunnan, 19.0% of whom were detected to be HIV-1 positive by serological testing. Partial HIV-1 p17, pol, vif-env, and env genes were amplified from the positive samples and were sequenced. Phylogenetic and HIV-1 subtyping analyses revealed that HIV-1 recombinant forms (RFs), including RF_BC (36.4%), RF_01BC (26.1%), RF_01C (9.1%) and RF_01B (1.1%), were predominant among this cohort. Of the identified HIV-1 strains, 14.8%, 9.1% and 3.4% belonged to subtype C, CRF01_AE and subtype B, respectively. Transmission cluster analysis showed that sequences from the Yunnan-mIDUs formed transmission clusters not only with those from Burmese IDUs but also with those from Chinese IDUs, indicating that Yunnan-mIDUs might acquire HIV-1 infection from or spread HIV-1 to both Burmese and Chinese IDUs. Phylogeographic analyses revealed three cross-border transmission patterns associated with Yunnan-mIDUs, in which Yunnan-mIDUs served as the crucial nodes linking the Burmese and Chinese IDUs. These results suggest that Yunnan-mIDUs are a potential viral reservoir for the diffusion of HIV-1 in Yunnan and play a pivotal role in the bidirectional cross-border transmission of HIV-1 in the China-Myanmar border region. More intervention efforts that focus on Yunnan-mIDUs are recommended in Yunnan’s campaign against HIV/AIDS.