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

• Published in: The Kaohsiung journal of medical sciences Vol. 31; no. 9; pp. 445 - 453
• Main Authors: Oyomopito, Rebecca A, Chen, Yen-Ju, Sungkanuparph, Somnuek, Kantor, Rami, Merati, Tuti, Yam, Wing-Cheong, Sirisanthana, Thira, Li, Patrick C.K, Kantipong, Pacharee, Phanuphak, Praphan, Lee, Chris K.C, Kamarulzaman, Adeeba, Ditangco, Rossana, Huang, Szu-Wei, Sohn, Annette H, Law, Matthew, Chen, Yi Ming A
• Format: Journal Article
• Language: English
• Published: China (Republic : 1949- ) Elsevier Taiwan 01.09.2015; Wiley
• Subjects: Adult; Asia; Asia, Southeastern - epidemiology; CRF01_AE; Female; HIV exposure; HIV Infections - epidemiology; HIV Infections - transmission; HIV Infections - virology; HIV-1 - physiology; Humans; Internal Medicine; Male; Phylogeny; Risk Factors; Subtype B; Asia, Southeastern; HIV exposure; Asia; CRF01_AE; Subtype B
• ISSN: 1607-551X; 2410-8650
• DOI: 10.1016/j.kjms.2015.07.002

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.