Molecular Epidemiology Of Newly Reported HIV-1 Infections In Ganzhou

Objective:Since the first indigenous case of AIDS was discovered in Yunnan Province in1989,the number of HIV-1 infections in China has been on the rise year by year.Timely molecular epidemiological studies of HIV-1 are crucial to reveal the prevalence and changes of HIV-1,and can provide reasonable guidance and scientific basis for the continuous monitoring and prevention and control of the AIDS epidemic in various regions.Although Ganzhou,Jiangxi Province,is a low HIV-1 endemic area,the number of HIV-1 infections has continued to increase rapidly in recent years,and the molecular epidemiological characteristics of HIV-1 in Ganzhou have rarely been reported.Therefore,this study aimed to conduct a cross-sectional study of newly reported HIV-1 infections in Ganzhou,Jiangxi Province,and explore the molecular epidemiological characteristics of HIV-1 in the local newly reported HIV-1 infections.Methods:In this study,plasma samples and demographic information were collected from newly reported HIV-1-infected patients,who identified and managed by the Center for Disease Control and Prevention in Ganzhou,Jiangxi Province from August 2020-August 2021.Viral nucleic acids were extracted from patients’ plasma samples,reverse transcribed into c DNA,and then the full-length sequence of HIV-1 pol gene was amplified by nested PCR.Then,phylogenetic analysis,recombination analysis,and drug resistance analysis were performed to determine the sequence subtypes and drug resistance status and to elucidate the molecular epidemiological characteristics of newly reported HIV-1 infected patients in Ganzhou.Results:(1)A total of 529 samples were collected,and the study population was predominantly older HIV-1-infected patients aged 50 years or older,accounting for58.0%.Infected persons were predominantly male,accounting for 78.4%.Marital status was predominantly married,accounting for 71.6%.The channels of transmission was mainly heterosexual,accounting for 88.1%.Educational level was mainly junior high school,accounting for 39.3%,followed by elementary school,accounting for 36.7%.Infected people were mainly in the general outpatient clinic,accounting for 60.5%.The occupation of infected people was mainly farming,accounting for 47.3%.Infected persons living in the counties were mainly infected,accounting for 58.4%.(2)The full-length HIV-1 pol gene was successfully amplified in 102 samples,and the results of phylogenetic and recombination analyses showed that there were seven prevalent HIV-1 subtypes among newly reported HIV-1-infected patients in Ganzhou,namely CRF07＿BC(30.4%),CRF08＿BC(23.6%),CRF01＿AE(19.6%),RF＿BC(17.7%),CRF55＿01B(5.9%),B(1.9%),and RF＿01BC(0.9%).(3)RF＿BC is a strain found for the first time in Ganzhou,formed by CRF07＿BC and CRF08＿BC through second-generation recombination,with a prevalence rate of17.7%,and is a potentially prevalent circulating recombinant form in Ganzhou.(4)Statistical analysis showed that the prevalent subtype distribution of newly reported HIV-1 infected patients in Ganzhou showed statistically significant differences in age and current address,while there were no statistical differences in gender,mode of transmission,marital status,education level,population sent for testing,and occupation.(5)A total of 7 out of 102 pol full-length gene sequences were detected with varying degrees of drug resistance mutations,with a resistance rate of 6.8%.The drug-resistant mutant were mainly resistant to non-nucleoside reverse transcriptase inhibitors.Conclusion:The HIV-1 subtypes in Ganzhou are complex and diverse,with CRF07＿BC,CRF08＿BC and CRF01＿AE as the main prevalent subtypes,and the secondgeneration recombinant strain RF＿BC is prevalent in Ganzhou for the first time with a high prevalence rate.In addition,primary drug resistance exists among newly reported HIV-1 infected patients in Ganzhou,and the level of drug resistance is in a moderate epidemic state.Therefore,extensive and continuous molecular epidemiological surveillance is necessary and urgent to better monitor the current status of HIV-1 prevalence in Ganzhou.