Centre of Excellence for Research in AIDS (CERiA), Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.
PLoS One. 2013 Jun 20;8(6):e67286. doi: 10.1371/journal.pone.0067286. Print 2013.
HIV-1 epidemics among men who have sex with men (MSM) continue to expand in developed and developing countries. Although HIV infection in MSM is amongst the highest of the key affected populations in many countries in Southeast Asia, comprehensive molecular epidemiological study of HIV-1 among MSM remains inadequate in the region including in Malaysia. Here, we reported the phylodynamic profiles of HIV-1 genotypes circulating among MSM population in Kuala Lumpur, Malaysia. A total of n = 459 newly-diagnosed treatment-naïve consenting subjects were recruited between March 2006 and August 2012, of whom 87 (18.9%) were self-reported MSM. Transmitted drug resistance mutations were absent in these isolates. Cumulatively, phylogenetic reconstructions of the pro-rt gene (HXB2∶2253-3275) showed that HIV-1 subtype B and CRF01_AE were predominant and contributed to approximately 80% of the total HIV-1 infection among MSM. In addition to numerous unique transmission lineages within these genotypes, twelve monophyletic transmission clusters of different sizes (2-7 MSM sequences, supported by posterior probability value of 1) were identified in Malaysia. Bayesian coalescent analysis estimated that the divergence times for these clusters were mainly dated between 1995 and 2005 with four major transmission clusters radiating at least 12 years ago suggesting that active spread of multiple sub-epidemic clusters occurred during this period. The changes in effective population size of subtype B showed an exponential growth within 5 years between 1988 and 1993, while CRF01_AE lineage exhibited similar expansion between 1993 and 2003. Our study provides the first insight of the phylodynamic profile of HIV-1 subtype B and CRF01_AE circulating among MSM population in Kuala Lumpur, Malaysia, unravelling the importance of understanding transmission behaviours as well as evolutionary history of HIV-1 in assessing the risk of outbreak or epidemic expansion.
在发达国家和发展中国家，男男性行为者（MSM）中的 HIV-1 疫情继续扩大。尽管在许多东南亚国家，MSM 中的 HIV 感染率是所有重点受影响人群中最高的，但包括马来西亚在内的该地区对 MSM 中的 HIV-1 进行全面的分子流行病学研究仍然不足。在这里，我们报告了在马来西亚吉隆坡的 MSM 人群中循环的 HIV-1 基因型的系统发育概况。2006 年 3 月至 2012 年 8 月期间，共招募了 459 名新诊断、未经治疗、同意的受试者，其中 87 名（18.9%）自我报告为 MSM。这些分离株中不存在传播耐药性突变。总共，对前 rt 基因（HXB2∶2253-3275）的系统发育重建表明，HIV-1 亚型 B 和 CRF01_AE 是主要的，占 MSM 中 HIV-1 总感染的约 80%。除了这些基因型内的许多独特传播谱系外，还在马来西亚鉴定了 12 个大小不同的单系传播群（2-7 个 MSM 序列，后验概率值为 1）。贝叶斯合并分析估计，这些群的分歧时间主要发生在 1995 年至 2005 年之间，其中四个主要传播群至少在 12 年前辐射，表明在这段时间内发生了多个亚流行群的活跃传播。亚型 B 的有效种群大小的变化在 1988 年至 1993 年的 5 年内呈指数增长，而 CRF01_AE 谱系在 1993 年至 2003 年期间表现出类似的扩张。我们的研究首次提供了在马来西亚吉隆坡的 MSM 人群中循环的 HIV-1 亚型 B 和 CRF01_AE 的系统发育概况，揭示了了解 HIV-1 传播行为以及进化史在评估暴发或流行扩大风险方面的重要性。
