Molecular Epidemiology of HIV-1 Subtype B, CRF01_AE, and CRF07_BC Infection Among Injection Drug Users in Taiwan

Chen, Yen–Ju; Huang, Yu Huei; Chuang, Shao Yuan; Kao, Diana; Lan, Yu Ching; Yang, Jyh Yuan; Chen, Yi Ming Arthur

doi:10.1097/qai.0b013e3181ccba1a

Cited by 14 publications

(22 citation statements)

References 37 publications

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“…Prior HIV-1 molecular epidemiology studies performed in Asia were mainly focused on the transmission of locally predominant HIV-1 genotypes [7], [10], [13], [14]. There was limited number of studies which focused on new HIV-1 group M recombinant transmission.…”

Section: Discussionmentioning

confidence: 99%

Increased Genetic Diversity of HIV-1 Circulating in Hong Kong

et al. 2010

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HIV-1 group M strains are characterized into 9 pure subtypes and 48 circulating recombinant forms (CRFs). Recent studies have identified the presence of new HIV-1 recombinants in Hong Kong and their complexity continues to increase. This study aims to characterize the HIV-1 genetic diversity in Hong Kong. Phylogenetic analyses were performed by using HIV-1 pol sequences including protease and partial reverse transcriptase isolated from 1045 local patients in Hong Kong from 2003 to 2008. For the pol sequences with unassigned genotype, the evidence of recombination was determined by using sliding-window based bootscan plots and their env C2V3 region were also sequenced. Epidemiological background of these patients was further collected. The pol phylogenetic analyses highlighted the extent of HIV-1 genetic diversity in Hong Kong. Subtype B (450/1045; 43.1%) and CRF01_AE (469/1045; 44.9%) variants were clearly predominant. Other genotypes (126/1045; 12.1%) including 3 defined subtypes, 10 CRFs, 1 unassigned subtype and 33 recombinants with 11 different mosaic patterns were observed. Recombinants of subtype B and CRF01_AE were mainly found among local Chinese MSM throughout 2004 to 2008, while the CRF02_AG and subtype G recombinants were circulating among non-Chinese Asian population in Hong Kong through heterosexual transmission starting from 2008. Our study demonstrated the complex recombination of HIV-1 in Hong Kong and the need in developing surveillance system for tracking the distribution of new HIV-1 genetic variants.

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Section: Discussionmentioning

confidence: 99%

Increased Genetic Diversity of HIV-1 Circulating in Hong Kong

et al. 2010

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“…Subtype B', that soon became the predominant B clade in China (Graf et al, 1998; Lau et al, 2007), and subtype C recombined to generate two related but distinct strains, CRF07_BC and CRF08_BC, which trace their origin to Yunnan and fueled the epidemic among PWID in Northwestern, Southeastern and Northeastern China, and to Taiwan (CRF07_BC) (Han et al, 2015; He et al, 2012; Laeyendecker et al, 2005; Lau et al, 2007; Li et al, 2015; Lin et al, 2006; Piyasirisilp et al, 2000; Takebe et al, 2010; Tee et al, 2008). CRF07_BC has also become the predominant strain among PWID (>80%) in Taiwan (Chen et al, 2012, 2010; Huang et al, 2014; Lin et al, 2006). Finally, CRF01_AE, imported from surrounding countries and following drug trafficking routes, was detected in PWID in the provinces of Yunnan, Guangdong, and Guangxi in the mid-1990s (Beyrer et al, 2000; He et al, 2012; Yu et al, 1999).…”

Section: Molecular Epidemiology Of Hiv Among Pwid In Asiamentioning

confidence: 99%

Overview of HIV molecular epidemiology among people who inject drugs in Europe and Asia

Nikolopoulos

Kostaki

Paraskevis

2016

Infection, Genetics and Evolution

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HIV strains continuously evolve, tend to recombine and new circulating variants are being discovered. Novel strains complicate efforts to develop a vaccine against HIV and may exhibit higher transmission efficiency and virulence, and elevated resistance to antiretroviral agents. The United Nations Joint Programme on HIV/AIDS (UNAIDS) set an ambitious goal to end HIV as a public health threat by 2030 through comprehensive strategies that include epidemiological input as the first step of the process. In this context, molecular epidemiology becomes invaluable as it captures trends in HIV evolution rates that shape epidemiological pictures across several geographical areas. This review briefly summarizes the molecular epidemiology of HIV among people who inject drugs (PWID) in Europe and Asia. Following high transmission rates of subtype G and CRF14_BG among PWID in Portugal and Spain, two European countries, Greece and Romania, experienced recent HIV outbreaks in PWID that consisted of multiple transmission clusters including subtypes B, A, F1 and recombinants CRF14_BG and CRF35_AD. The latter was first identified in Afghanistan. Russia, Ukraine and other Former Soviet Union (FSU) states are still facing the devastating effects of epidemics in PWID produced by AFSU (also known as IDU-A), BFSU (known as IDU-B), and CRF03_AB. In Asia, CRF01_AE and subtype B (Western B and Thai B) travelled from PWID in Thailand to neighboring countries. Recombination hotspots in South China, Northern Myanmar, and Malaysia have been generating several intersubtype and inter-CRF recombinants (e.g. CRF07_BC, CRF08_BC, CRF33_01B etc.) increasing the complexity of HIV molecular patterns.

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“…Subtype B infections are primarily reported in Japan and the Republic of Korea (South Korea) 17–20 . In China’s Special Administrative Region of Hong Kong and in Malaysia, subtype B and CRF01_AE co-circulate 17,21,22 while in Taiwan, subtype B, CRF01_AE and CRF07_BC have been found 23,24 . Epidemic distributions differ depending on the sub-populations at risk with subtype B frequently found in injecting drug users and men-who-have-sex-with-men (MSM), whereas CRF01_AE is more commonly found in heterosexual populations 25 .…”

Section: Introductionmentioning

confidence: 99%

Evaluating Immunologic Response and Clinical Deterioration in Treatment-Naive Patients Initiating First-Line Therapies Infected With HIV–1 CRF01_AE and Subtype B

Oyomopito

Sungkanuparph

et al. 2013

JAIDS Journal of Acquired Immune Deficiency Syndromes

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Background HIV-1 group M viruses diverge 25%–35% in envelope, important for viral attachment during infection, and 10–15% in the pol region, under selection pressure from common antiretrovirals. In Asia, subtypes B and CRF01_AE are common genotypes. Our objectives were to determine whether clinical, immunologic or virologic treatment responses differed by genotype in treatment-naïve patients initiating first-line therapy. Methods Prospectively collected, longitudinal data from patients in Thailand, Hong Kong, Malaysia, Japan, Taiwan and South Korea were provided for analysis. Covariates included demographics, hepatitis B and C coinfections, baseline CD4 T lymphocyte count and plasma HIV-1 RNA levels. Clinical deterioration (a new diagnosis of CDC category B/AIDS-defining illness or death) was assessed by proportional hazards models. Surrogate endpoints were 12-month change in CD4 cell count and virologic suppression post-therapy, evaluated by linear and logistic regression, respectively. Results Of 1105 patients, 1036 (93.8%) infected with CRF01_AE or subtype B were eligible for inclusion in clinical deterioration analyses and contributed 1546.7 person-years of follow-up (median:413 days, IQR:169–672 days). Patients >40 years demonstrated smaller immunological increases (p=0.002) and higher risk of clinical deterioration (HR=2.17; p=0.008). Patients with baseline CD4 cell counts >200 cells/μL had lower risk of clinical deterioration (HR=0.373; p=0.003). A total of 532 patients (48.1% of eligible) had CD4 counts available at baseline and 12 months post-therapy for inclusion in immunolgic analyses. Patients infected with subtype B had larger increases in CD4 counts at 12 months (p=0.024). A total of 530 patients (48.0% of eligible) were included in virologic analyses with no differences in response found between genotypes. Conclusions Results suggest that patients infected with CRF01_AE have reduced immunologic response to therapy at 12 months, compared to subtype-B-infected counterparts. Clinical deterioration was associated with low baseline CD4 counts and older age. The lack of differences in virologic outcomes suggests that all patients have opportunities for virologic suppression.

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Molecular Epidemiology of HIV-1 Subtype B, CRF01_AE, and CRF07_BC Infection Among Injection Drug Users in Taiwan

Abstract: Sharing dissolved heroine solution is a neglected risk factor associated with HIV-1 infection and it should be emphasized in the AIDS education and harm reduction programs immediately.

Cited by 14 publications

References 37 publications

Increased Genetic Diversity of HIV-1 Circulating in Hong Kong

Increased Genetic Diversity of HIV-1 Circulating in Hong Kong

Overview of HIV molecular epidemiology among people who inject drugs in Europe and Asia

Evaluating Immunologic Response and Clinical Deterioration in Treatment-Naive Patients Initiating First-Line Therapies Infected With HIV–1 CRF01_AE and Subtype B

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