An Minghui, Zheng Chenli, Chen Lin, Li Hao, Zhang Yan, Gan Yongxia, Zhao Bin, Zhang Hui, Han Xiaoxu, Zhao Jin, Shang Hong
State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, NHC Key Laboratory of AIDS Prevention and Treatment, National Clinical Research Center for Laboratory Medicine, The First Hospital of China Medical University, China Medical University, Shenyang, China.
Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, Liaoning, China.
J Infect Dis. 2025 Feb 4;231(1):137-146. doi: 10.1093/infdis/jiae428.
Shenzhen, a city with a substantial mobile population, was identified as the first discovered region of human immunodeficiency virus-1 (HIV-1) CRF55_01B and epicenter of its severe epidemic. During the implementation of venue-based behavioral interventions and the "treat-all" policy, identifying the patterns of spread and transmission hotspots of CRF55_01B is imperative.
In this study, 1450 partial pol sequences, with demographic information, were collected from all newly diagnosed CRF55_01B infections in Shenzhen from 2008 to 2020. Molecular networks were constructed using the maximum likelihood and time-resolve phylogenies. Transmission rates, effective reproduction numbers (Re) of clusters, and viral dispersal were evaluated using Bayesian inference.
In total, 526 sequences formed 114 clusters, including 7 large clusters. The status and size of clusters were strongly correlated with age, ethnicity, occupation, and CD4+ T-cell counts. The transmission rates of clusters were significantly higher than the national epidemic estimate. Four large clusters had Re exceeding 1 at the end of the sampling period. Immigrants from Guangdong and Hunan, along with local residents, were identified as the transmission hubs, with heterosexual men being the main source and MSM being the main destination. The virus exhibited a high movement frequency from individuals aged 30-49 years toward diverse age groups.
This study demonstrated that the hidden CRF55_01B transmissions continued despite current combined interventions in Shenzhen, and at-risk individuals susceptible to infection or transmission were identified, potentially serving as targets for more effective prevention and control of the local epidemic, thereby mitigating cross-regional spread nationwide due to population migration.
深圳是一个拥有大量流动人口的城市，被确定为人类免疫缺陷病毒1型（HIV-1）CRF55_01B的首个发现地区及其严重流行的中心。在实施基于场所的行为干预措施和“全面治疗”政策期间，识别CRF55_01B的传播模式和传播热点至关重要。
在本研究中，收集了2008年至2020年深圳所有新诊断的CRF55_01B感染病例的1450条带有人口统计学信息的部分pol序列。使用最大似然法和时间分辨系统发育法构建分子网络。采用贝叶斯推断评估传播率、聚类的有效繁殖数（Re）和病毒扩散情况。
总共526条序列形成了114个聚类，包括7个大聚类。聚类的状态和规模与年龄、种族、职业和CD4+T细胞计数密切相关。聚类的传播率显著高于全国流行估计值。在采样期结束时，四个大聚类的Re超过1。来自广东和湖南的移民以及当地居民被确定为传播枢纽，异性恋男性是主要来源，男男性行为者是主要目的地。该病毒在30至49岁的个体中向不同年龄组的传播频率较高。
本研究表明，尽管深圳目前采取了联合干预措施，但CRF55_01B的隐匿传播仍在继续，并且确定了易感染或传播的高危个体，这些个体可能成为更有效预防和控制当地疫情的目标，从而减轻因人口迁移导致的全国跨地区传播。
