分子网络揭示了在中国广州，处于 HIV-1 感染边缘角色的异性恋女性中，与 MSM 存在复杂相互作用。
Molecular networks reveal complex interactions with MSM in heterosexual women living with HIV-1 who play peripheral roles in Guangzhou, China.
机构信息
Huangpu District Center for Disease Control and Prevention, Guangzhou, PR China.
Guangzhou Center for Disease Control and Prevention, Guangzhou, PR China.
出版信息
Acta Trop. 2023 Sep;245:106953. doi: 10.1016/j.actatropica.2023.106953. Epub 2023 May 22.
BACKGROUND
With the number of newly diagnosed HIV-positive heterosexual women increasing yearly, it is urgent to understand HIV-1 transmission among heterosexual women in Guangzhou, China.
METHODS
HIV-1 pol sequences were obtained from people living with HIV-1 during 2008 to 2017 in Guangzhou, China. A molecular network was constructed using HIV-1 TRAnsmission Cluster Engine with 1.5% genetic distance. Potential linkage and centrality metric were measured with Cytoscape. Transmission pathways between heterosexual women and men who have sex with men (MSM) were determined using Bayesian phylogenetic analysis.
RESULTS
In the network, 1799 (62.6%) MSM, 692 (24.1%) heterosexual men and 141 (4.9%) heterosexual women formed 259 clusters. Molecular clusters including MSM and heterosexuals were more likely to form larger networks (P<0.001). Nearly half of the heterosexual women (45.4%) were linked to heterosexual men and 17.7% to MSM, but only 0.9% of MSM were linked to heterosexual women. Thirty-three (23.4%) heterosexual women linked to at least one MSM node and were in peripheral role. Compared to general heterosexual women, the proportion of heterosexual women linked to MSM infected with CRF55_01B (P<0.001) and CRF07_BC (P<0.001) was higher than that of other subtypes, and the proportion diagnosed between 2012 and 2017 (P = 0.001) was higher than that in 2008-2012. In MCC trees, 63.6% (21/33) of the heterosexual women differentiated from the heterosexual evolutionary branch, while 36.4% (12/33) differentiated from the MSM evolutionary branch.
CONCLUSION
Heterosexual women living with HIV-1 were mainly linked to heterosexual men and were in peripheral positions in the molecular network. The role of heterosexual women in HIV-1 transmission was limited, but the interaction between MSM and heterosexual women were complex. Awareness of the HIV-1 infection status of sexual partners and active HIV-1 detection are needed for women.
背景
随着每年新诊断出的 HIV 阳性异性恋女性人数的增加，了解中国广州异性恋女性中的 HIV-1 传播情况迫在眉睫。
方法
从 2008 年至 2017 年期间在中国广州感染 HIV-1 的人群中获得 HIV-1 pol 序列。使用 HIV-1 传播簇引擎，以 1.5%的遗传距离构建分子网络。使用 Cytoscape 测量潜在的连接和中心性度量。使用贝叶斯系统发育分析确定异性恋女性和男男性行为者（MSM）之间的传播途径。
结果
在网络中，1799 名（62.6%）MSM、692 名（24.1%）异性恋男性和 141 名（4.9%）异性恋女性形成了 259 个簇。包括 MSM 和异性恋者的分子簇更有可能形成更大的网络（P<0.001）。近一半的异性恋女性（45.4%）与异性恋男性有关，17.7%与 MSM 有关，但只有 0.9%的 MSM 与异性恋女性有关。33 名（23.4%）异性恋女性与至少一个 MSM 节点有关，处于边缘地位。与普通异性恋女性相比，与 MSM 感染 CRF55_01B（P<0.001）和 CRF07_BC（P<0.001）的异性恋女性比例更高，2012 年至 2017 年诊断的比例（P=0.001）高于 2008-2012 年。在 MCC 树中，63.6%（21/33）的异性恋女性与异性恋进化分支分化，而 36.4%（12/33）与 MSM 进化分支分化。
结论
感染 HIV-1 的异性恋女性主要与异性恋男性有关，在分子网络中处于边缘地位。异性恋女性在 HIV-1 传播中的作用有限，但 MSM 和异性恋女性之间的相互作用是复杂的。需要了解性伴侣的 HIV-1 感染状况，并积极进行 HIV-1 检测。
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