Lam Caitlin R, Holtz Timothy H, Leelawiwat Wanna, Mock Philip A, Chonwattana Wannee, Wimonsate Wipas, Varangrat Anchalee, Thienkrua Warunee, Rose Charles, Chitwarakorn Anupong, Curlin Marcel E
1 Rollins School of Public Health, Emory University , Atlanta, Georgia .
2 Thailand Ministry of Public Health-U.S. Centers for Disease Control and Prevention Collaboration , Nonthaburi, Thailand .
AIDS Res Hum Retroviruses. 2017 Oct;33(10):1004-1012. doi: 10.1089/AID.2016.0119. Epub 2017 Jan 27.
HIV-1 incidence and prevalence remain high among men who have sex with men (MSM), and transgender women (TGW), in Thailand. To examine the link between epidemiologic factors and HIV-1 subtype transmission among Thai MSM, we compared covariates of infection with HIV CRF01_AE and other HIV strains among participants in the Bangkok MSM Cohort Study (BMCS). The BMCS was an observational cohort study of Thai MSM and TGW with up to 60 months of follow-up at 4 monthly intervals. Participants underwent HIV/sexually transmitted infections testing and provided behavioral data at each visit. Infecting viral strain was characterized by gene sequencing and/or multiregion hybridization assay. We correlated behavioral/clinical variables with infecting strain using Cox proportional hazards. Among a total of 1372 HIV seronegative enrolled participants with 4,192 person-years of follow-up, we identified 215 seroconverters between April 2006 and December 2014, with 177 infected with CRF01_AE and 38 with non-CRF01_AE subtype. Age 18-21 years (adjusted hazard ratio [AHR] 2.2, 95% confidence interval [CI]: 1.4-3.5), age 22-29 (AHR 1.6, 95% CI: 1.1-2.3), living alone (AHR 1.5, 95% CI: 1.1-2.1), drug use (AHR 2.2, 95% CI: 1.4-3.5), intermittent condom use (AHR 1.7, 95% CI: 1.3-2.3), any receptive anal intercourse (AHR 1.7, 95% CI: 1.2-2.4), group sex (AHR 1.5, 95% CI: 1.1-2.2), anti-herpes simplex virus type 1 (AHR 1.5, 95% CI: 1.1-2.1), and Treponema pallidum antibody positivity (AHR 2.5, 95% CI: 1.4-4.4) were associated with CRF01_AE infection. Age 18-21 years (AHR 5.1, 95% CI: 1.6-16.5), age 22-29 (AHR 3.6, 95% CI: 1.3-10.4), drug use (AHR 3.1, 95% CI: 1.3-7.5), group sex (AHR 2.4, 95% CI: 1.1-5.0), and hepatitis B virus surface antigen (AHR 3.6, 95% CI: 1.3-10.2) were associated with non-CRF01_AE infection. We observed several significant biological and behavioral correlates of infection with CRF01_AE and other HIV strains among Thai MSM. Divergence in correlates by strain may indicate differences in HIV transmission epidemiology between CRF01_AE and other strains. These differences could reflect founder effects, transmission within networks distinguished by specific risk factors, and possibly biological differences between HIV strains.
在泰国，男男性行为者（MSM）和变性女性（TGW）中，HIV-1发病率和流行率仍然很高。为了研究泰国男男性行为者中流行病学因素与HIV-1亚型传播之间的联系，我们比较了曼谷男男性行为者队列研究（BMCS）参与者中感染HIV CRF01_AE和其他HIV毒株的协变量。BMCS是一项针对泰国男男性行为者和变性女性的观察性队列研究，随访时间长达60个月，每4个月进行一次。参与者每次就诊时都要接受HIV/性传播感染检测并提供行为数据。通过基因测序和/或多区域杂交试验对感染的病毒株进行特征分析。我们使用Cox比例风险模型将行为/临床变量与感染毒株进行关联分析。在总共1372名HIV血清阴性的登记参与者中，随访时间为4192人年，我们在2006年4月至2014年12月期间确定了215名血清转化者，其中177人感染了CRF01_AE，38人感染了非CRF01_AE亚型。18至21岁（调整后风险比[AHR]2.2，95%置信区间[CI]：1.4 - 3.5）、22至29岁（AHR 1.6，95%CI：1.1 - 2.3）、独居（AHR 1.5，95%CI：1.1 - 2.1）、吸毒（AHR 2.2，95%CI：1.4 - 3.5）、间歇性使用避孕套（AHR 1.7，95%CI：1.3 - 2.3）、任何接受性肛交（AHR 1.7，95%CI：1.2 - 2.4）、群交（AHR 1.5，95%CI：1.1 - 2.2）、抗1型单纯疱疹病毒（AHR 1.5，95%CI：1.1 - 2.1）和梅毒螺旋体抗体阳性（AHR 2.5，95%CI：1.4 - 4.4）与CRF01_AE感染相关。18至21岁（AHR 5.1，95%CI：1.6 - 16.5）、22至29岁（AHR 3.6，95%CI：1.3 - 10.4）、吸毒（AHR 3.1，95%CI：1.3 - 7.5）、群交（AHR 2.4，95%CI：1.1 - 5.0）和乙肝病毒表面抗原（AHR 3.6，95%CI：1.3 - 10.2）与非CRF01_AE感染相关。我们观察到泰国男男性行为者中感染CRF01_AE和其他HIV毒株存在若干显著的生物学和行为关联。不同毒株的关联差异可能表明CRF01_AE与其他毒株在HIV传播流行病学上存在差异。这些差异可能反映了奠基者效应、在以特定风险因素区分的网络内的传播，以及HIV毒株之间可能的生物学差异。
