[Impact of HIV-1 genotypes and population mobility on HIV-1 transmission in Guangzhou: a molecular transmission network analysis].

OBJECTIVES

To investigate the impact of HIV-1 genotypes and population mobility on HIV-1 transmission in Guangzhou to obtain evidence for devising precision prevention and control strategies.

METHODS

Demographic data and HIV-1 pol sequences were obtained from 6783 newly diagnosed people living with HIV (PLWH) in 2008-2020 in Guangzhou, including 24.0% local Guangzhou residents, 0.9% mobile Guangzhou residents, 56.4% local non-Guangzhou residents, and 18.6% mobile non-Guangzhou residents. HIV-1 genotypes were determined and molecular transmission networks were constructed using HIV-TRACE. Degree centrality and multinomial logistic regression were used to identify the key characteristics of the PLWH and risk factors of HIV-1 transmission.

RESULTS

Among the PLWH, the dominated HIV-1 genotypes were CRF07_BC (39.6%), CRF01_AE (33.0%), and CRF55_01B (11.9%), and 43.3% of the PLWH formed 596 transmission clusters. Compared with subtype B, CRF01_AE (aOR=1.384, 95% CI: 1.072-1.798), CRF07_BC (aOR=2.462, 95% CI: 1.911-3.192), CRF55_01B (aOR=3.209, 95% CI: 2.424-4.271), and CRF59_01B (aOR=2.149, 95% CI: 1.437-3.219) were more likely to cluster. Population mobility was not associated with overall HIV-1 transmission, and local Guangzhou residents were more likely to be involved in CRF08_BC transmission (aOR=4.241, 95% CI: 1.494-12.790), whereas migrants had lower odds of transmitting CRF01_AE (aOR=0.740, 95% CI: 0.576-0.946) and subtype B (aOR=0.429, 95% CI: 0.182-0.922). The characteristics of high-risk individuals for HIV-1 transmission included local Guangzhou residents (aOR=1.390, 95% CI: 1.141-1.695), men (aOR=4.449, 95% CI: 2.402-8.242), MSM (aOR=1.783, 95% CI: 1.414-2.248), and infection with CRF07_BC (aOR=3.062, 95% CI: 1.963-4.777) or CRF55_01B (aOR=5.031, 95% CI: 3.159-8.014).

CONCLUSIONS

Local Guangzhou residents, though accounting for only 24.9% in the PLWH, have a high risk of HIV-1 transmission, to which HIV-1 genotypes and MSM are also important contributors. Molecular network analysis provide important assistance for precision prevention and control of HIV-1 transmission.