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Updated: Jul 1, 2025
Genotypic Inference of HIV-1 Tropism Using Population-based Sequencing of V3
Published on: December 27, 2010
The origin, dissemination, and molecular networks of HIV-1 CRF65_cpx strain in Hainan Island, China
Dee Yu1,2, Kaokao Zhu3, Mu Li1
1Guangxi Key Laboratory of AIDS Prevention and Treatment & Guangxi Colleges and Universities Key Laboratory of Prevention and Control of Highly Prevalent Diseases, School of Public Health, Guangxi Medical University, 22 Shuangyong Road, Nanning, 530021, China.
Insights
The HIV-1 CRF65_cpx strain originated in Beijing and spread to Hainan Island, China, primarily among men who have sex with men (MSM). Haikou emerged as a central hub for transmission, with targeted interventions needed to control the epidemic.
Area of Science:
- Molecular epidemiology of HIV-1 strains
- Viral phylodynamics and transmission networks
- Public health and infectious disease control
Background:
- The HIV-1 CRF65_cpx strain harbors drug-resistant mutations, posing a risk for virologic failure.
- CRF65_cpx is the fourth most prevalent HIV-1 strain on Hainan Island, China.
- The origin and molecular epidemiology of CRF65_cpx on Hainan Island are not well understood.
Purpose of the Study:
- To investigate the spatial origins and dissemination patterns of HIV-1 CRF65_cpx on Hainan Island.
- To understand the transmission dynamics and molecular epidemiology of this specific HIV-1 strain.
- To identify potential hotspots and key populations for targeted HIV intervention strategies.
Main Methods:
- Phylogenetic analysis of 58 HIV-1 CRF65_cpx pol sequences collected between 2018-2021.
- Bayesian coalescent-based approach to infer evolutionary history and introduction.
- HIV-TRACE tool for constructing transmission networks and analyzing viral migration patterns.
Main Results:
- The CRF65_cpx strain on Hainan Island originated in Beijing and was introduced around 2013, primarily among men who have sex with men (MSM).
- Haikou was identified as the central epidemic hub, with subsequent spread to other locations on Hainan Island.
- Transmission networks revealed viral migration from older to younger age groups and from MSM to heterosexual individuals.
Conclusions:
- Haikou is a significant hotspot for HIV-1 CRF65_cpx transmission on Hainan Island.
- Middle-aged MSM represent a key population for HIV-1 CRF65_cpx transmission.
- Targeted public health interventions in identified hotspots and key populations are crucial for controlling the HIV epidemic.
Background:
HIV-1 CRF65_cpx strain carries drug-resistant mutations, which raises concerns about its potential for causing virologic failure. The CRF65_cpx ranks as the fourth most prevalent on Hainan Island, China. However, the origin and molecular epidemiology of CRF65_cpx strains in this area remain unclear. This study aims to estimate the spatial origins and dissemination patterns of HIV-1 CRF65_cpx in this specific region.
Methods:
Between 2018 and 2021, a total of 58 pol sequences of the CRF65_cpx were collected from HIV-positive patients on Hainan Island. The available CRF65_cpx pol sequences from public databases were compiled. The HIV-TRACE tool was used to construct transmission networks. The evolutionary history of the introduction and dissemination of HIV-1 CRF65_cpx on Hainan Island were analyzed using phylogenetic analysis and the Bayesian coalescent-based approach.
Results:
Among the 58 participants, 89.66% were men who have sex with men (MSM). The median age was 25 years, and 43.10% of the individuals had a college degree or above. The results indicated that 39 (67.24%) sequences were interconnected within a single transmission network. A consistent expansion was evident from 2019 to 2021, with an incremental annual addition of four sequences into the networks. Phylodynamic analyses showed that the CRF65_cpx on Hainan Island originated from Beijing (Bayes factor, BF = 17.4), with transmission among MSM on Hainan Island in 2013.2 (95%HPD: 2012.4, 2019.5), subsequently leading to an outbreak. Haikou was the local center of the CRF65_cpx epidemic. This strain propagated from Haikou to other locations, including Sanya (BF > 1000), Danzhou (BF = 299.3), Chengmai (BF = 27.0) and Tunchang (BF = 16.3). The analyses of the viral migration patterns between age subgroups and risk subgroups revealed that the viral migration directions were from "25-40 years old" to "17-24 years old" (BF = 14.6) and to "over 40 years old" (BF = 17.6), and from MSM to heterosexuals (BF > 1000) on Hainan Island.
Conclusion:
Our analyses elucidate the transmission dynamics of CRF65_cpx strain on Hainan Island. Haikou is identified as the potential hotspot for CRF65_cpx transmission, with middle-aged MSM identified as the key population. These findings suggest that targeted interventions in hotspots and key populations may be more effective in controlling the HIV epidemic.
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