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Abstract：
OBJECTIVE: The objective of this study was to conduct a comprehensive analysis of the molecular transmission networks and transmitted drug resistance (TDR) patterns among individuals newly diagnosed with HIV-1 in Nanjing.
METHODS: Plasma samples were collected from newly diagnosed HIV patients in Nanjing between 2019 and 2021. The HIV pol gene was amplified, and the resulting sequences were utilized for determining TDR, identifying viral subtypes, and constructing molecular transmission network. Logistic regression analyses were employed to investigate the epidemiological characteristics associated with molecular transmission clusters.
RESULTS: A total of 1161 HIV pol sequences were successfully extracted from newly diagnosed individuals, each accompanied by reliable epidemiologic information. The analysis revealed the presence of multiple HIV-1 subtypes, with CRF 07_BC (40.57%) and CRF01_AE (38.42%) being the most prevalent. Additionally, six other subtypes and unique recombinant forms (URFs) were identified. The prevalence of TDR among the newly diagnosed cases was 7.84% during the study period. Employing a genetic distance threshold of 1.50%, the construction of the molecular transmission network resulted in the identification of 137 clusters, encompassing 613 nodes, which accounted for approximately 52.80% of the cases. Multivariate analysis indicated that individuals within these clusters were more likely to be aged ≥ 60, unemployed, baseline CD4 cell count ≥ 200 cells/mm3, and infected with the CRF119_0107 (P < 0.05). Furthermore, the analysis of larger clusters revealed that individuals aged ≥ 60, peasants, those without TDR, and individuals infected with the CRF119_0107 were more likely to be part of these clusters.
CONCLUSIONS: This study revealed the high risk of local HIV transmission and high TDR prevalence in Nanjing, especially the rapid spread of CRF119_0107. It is crucial to implement targeted interventions for the molecular transmission clusters identified in this study to effectively control the HIV epidemic.
METHODS: Plasma samples were collected from newly diagnosed HIV patients in Nanjing between 2019 and 2021. The HIV pol gene was amplified, and the resulting sequences were utilized for determining TDR, identifying viral subtypes, and constructing molecular transmission network. Logistic regression analyses were employed to investigate the epidemiological characteristics associated with molecular transmission clusters.
RESULTS: A total of 1161 HIV pol sequences were successfully extracted from newly diagnosed individuals, each accompanied by reliable epidemiologic information. The analysis revealed the presence of multiple HIV-1 subtypes, with CRF 07_BC (40.57%) and CRF01_AE (38.42%) being the most prevalent. Additionally, six other subtypes and unique recombinant forms (URFs) were identified. The prevalence of TDR among the newly diagnosed cases was 7.84% during the study period. Employing a genetic distance threshold of 1.50%, the construction of the molecular transmission network resulted in the identification of 137 clusters, encompassing 613 nodes, which accounted for approximately 52.80% of the cases. Multivariate analysis indicated that individuals within these clusters were more likely to be aged ≥ 60, unemployed, baseline CD4 cell count ≥ 200 cells/mm3, and infected with the CRF119_0107 (P < 0.05). Furthermore, the analysis of larger clusters revealed that individuals aged ≥ 60, peasants, those without TDR, and individuals infected with the CRF119_0107 were more likely to be part of these clusters.
CONCLUSIONS: This study revealed the high risk of local HIV transmission and high TDR prevalence in Nanjing, especially the rapid spread of CRF119_0107. It is crucial to implement targeted interventions for the molecular transmission clusters identified in this study to effectively control the HIV epidemic.
摘要：
目的：本研究的目的是对南京地区新诊断HIV-1个体的分子传播网络和传播耐药（TDR）模式进行综合分析。
方法：收集2019年至2021年南京初诊HIV患者的血浆样本。HIVpol基因被扩增，得到的序列用于确定TDR，鉴定病毒亚型,构建分子传输网络。采用Logistic回归分析研究与分子传播集群相关的流行病学特征。
结果：从新诊断的个体中成功提取了1161个HIVpol序列，每个伴随着可靠的流行病学信息。分析显示存在多种HIV-1亚型，CRF07_BC（40.57％）和CRF01_AE（38.42％）最为普遍。此外,鉴定出其他6种亚型和独特的重组形式(URFs).在研究期间，新诊断病例中TDR的患病率为7.84％。采用1.50%的遗传距离阈值，分子传输网络的构建导致了137个簇的识别，包含613个节点，约占病例的52.80%。多变量分析表明，这些群体中的个体更有可能年龄≥60岁，失业，基线CD4细胞计数≥200个细胞/mm3，并感染CRF119_0107（P<0.05）。此外，对较大集群的分析表明，年龄≥60岁的个体，农民，那些没有TDR的，感染CRF119_0107的个体更有可能是这些集群的一部分。
结论：这项研究揭示了南京地区HIV局部传播的高风险和高TDR患病率，特别是CRF119_0107的快速传播。对于本研究中确定的分子传播集群实施有针对性的干预措施对于有效控制HIV流行至关重要。
方法：收集2019年至2021年南京初诊HIV患者的血浆样本。HIVpol基因被扩增，得到的序列用于确定TDR，鉴定病毒亚型,构建分子传输网络。采用Logistic回归分析研究与分子传播集群相关的流行病学特征。
结果：从新诊断的个体中成功提取了1161个HIVpol序列，每个伴随着可靠的流行病学信息。分析显示存在多种HIV-1亚型，CRF07_BC（40.57％）和CRF01_AE（38.42％）最为普遍。此外,鉴定出其他6种亚型和独特的重组形式(URFs).在研究期间，新诊断病例中TDR的患病率为7.84％。采用1.50%的遗传距离阈值，分子传输网络的构建导致了137个簇的识别，包含613个节点，约占病例的52.80%。多变量分析表明，这些群体中的个体更有可能年龄≥60岁，失业，基线CD4细胞计数≥200个细胞/mm3，并感染CRF119_0107（P<0.05）。此外，对较大集群的分析表明，年龄≥60岁的个体，农民，那些没有TDR的，感染CRF119_0107的个体更有可能是这些集群的一部分。
结论：这项研究揭示了南京地区HIV局部传播的高风险和高TDR患病率，特别是CRF119_0107的快速传播。对于本研究中确定的分子传播集群实施有针对性的干预措施对于有效控制HIV流行至关重要。
