National Reference Laboratory, STD AIDS Cooperative Central Laboratory, San Lazaro Hospital, Manila, Philippines.
J Med Virol. 2013 Dec;85(12):2057-64. doi: 10.1002/jmv.23701. Epub 2013 Aug 19.
A concentrated human immunodeficiency virus (HIV) epidemic might have started in the Philippines. A subsequent characterization of viruses was carried out to estimate HIV transmission modes. Most HIV strains from injecting drug users belonged to subtype-B. CRF-01 was a major subtype harbored by three other at-risk populations: male visa applicants who had sex with men, "men who have sex with men," and visa applicants. An HIV phylogeny suggested that two strain groups of injecting drug users and others circulated separately. In contrast, there was substantial genetic overlap between two strain groups from "men who have sex with men" and visa applicants. Mean nucleotide distance within strains was shorter among subtype-B strains harbored by the injecting drug users (0.010) than among CRF-01 strains of the other three populations: male visa applicants who had sex with men (0.034), "men who have sex with men" (0.023), and visa applicants (0.032). Closely related strains of hepatitis C virus were derived from not only HIV-positive but also -negative individuals. These results suggest that there is potential for transmission from visa applicants to "men who have sex with men," and that once HIV occurs in injecting drug users, it spreads rapidly among them. Close contacts of hepatitis C virus carriers composed of HIV-negative and -positive individuals indicated ongoing HIV spread via blood and possible intervention points. Large-scale analysis is needed to provide more precise information on the transmission directions and to help curb the growth of this HIV epidemic in the Philippines.
菲律宾可能出现了集中的人类免疫缺陷病毒（HIV）流行。随后对病毒进行了特征描述，以估计 HIV 传播模式。大多数注射吸毒者的 HIV 毒株属于 B 亚型。CRF-01 是其他三个高危人群（与男性发生性关系的男性签证申请人、男男性接触者和签证申请人）中主要的亚型。HIV 系统发育分析表明，两组注射吸毒者和其他人的毒株分别循环。相比之下，男男性接触者和签证申请人两组毒株之间存在大量遗传重叠。两组注射吸毒者的 B 亚型毒株之间的核苷酸差异较小（0.010），而其他三个人群的 CRF-01 毒株的差异较大：与男性发生性关系的男性签证申请人（0.034）、男男性接触者（0.023）和签证申请人（0.032）。不仅从 HIV 阳性个体，还从 HIV 阴性个体中分离出了密切相关的丙型肝炎病毒株。这些结果表明，从签证申请人到男男性接触者存在传播的可能性，而且一旦 HIV 在注射吸毒者中出现，它会在他们中间迅速传播。丙型肝炎病毒携带者的密切接触者包括 HIV 阴性和阳性个体，表明 HIV 通过血液传播，存在可能的干预点。需要进行大规模分析，以提供更准确的传播方向信息，并帮助遏制菲律宾 HIV 疫情的蔓延。
