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Kaohsiung J Med Sci. 2015 Sep;31(9):445-53. doi: 10.1016/j.kjms.2015.07.002. Epub 2015 Aug 21.

Risk group characteristics and viral transmission clusters in South-East Asian patients infected with human immunodeficiency virus-1 (HIV-1) circulating recombinant form (CRF) 01_AE and subtype B.

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The Kirby Institute, University of New South Wales, Sydney, Australia.
Center for Infectious Disease and Cancer Research, Kaohsiung Medical University, Kaohsiung City, Taiwan.
Faculty of Medicine Ramathibodi Hospital, Mahidol University, Bangkok, Thailand.
Division of Infectious Diseases, Brown University Alpert Medical School, RI, USA.
Faculty of Medicine Udayana University & Sanglah Hospital, Bali, Indonesia.
Department of Microbiology, Queen Mary Hospital, Faculty of Medicine, The University of Hong Kong, Hong Kong, China.
Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, Thailand.
Chiangrai Prachanukroh Hospital, Chiangrai, Thailand.
HIV-NAT/Thai Red Cross AIDS Research Centre, Bangkok, Thailand.
Hospital Sungai Buloh, Sungai Buloh, Malaysia.
University Malaya Medical Centre, Kuala Lumpur, Malaysia.
Research Institute for Tropical Medicine, Manila, Philippines.
TREAT Asia, amfAR-The Foundation for AIDS Research, Bangkok, Thailand.
Center for Infectious Disease and Cancer Research, Kaohsiung Medical University, Kaohsiung City, Taiwan; Department of Microbiology, Kaohsiung Medical University, Kaohsiung City, Taiwan. Electronic address:


Human immunodeficiency virus (HIV)-1 epidemics in Asian countries are driven by varying exposures. The epidemiology of the regional pandemic has been changing with the spread of HIV-1 to lower-risk populations through sexual transmission. Common HIV-1 genotypes include subtype B and circulating recombinant form (CRF) 01_AE. Our objective was to use HIV-1 genotypic data to better quantify local epidemics. TASER-M is a multicenter prospective cohort of HIV-infected patients. Associations between HIV exposure, patient sex, country of sample origin and HIV-1 genotype were evaluated by multivariate logistic regression. Phylogenetic methods were used on genotypic data to investigate transmission relationships. A total of 1086 patients from Thailand, Hong Kong, Malaysia and the Philippines were included in analyses. Proportions of male patients within countries varied (Thailand: 55.6%, Hong Kong: 86.1%, Malaysia: 81.4%, Philippines: 93.8%; p < 0.001) as did HIV exposures (heterosexual contact: Thailand: 85.7%, Hong Kong, 46.2%, Malaysia: 47.8%, Philippines: 25.0%; p < 0.001). After adjustment, we found increased subtype B infection among men who have sex with men, relative to heterosexual-reported exposures (odds ratio = 2.4, p < 0.001). We further describe four transmission clusters of eight to 15 treatment naïve, predominantly symptomatic patients (two each for subtype B and CRF01_AE). Risk-group subpopulations differed with respect to the infecting HIV-1 genotype. Homosexual exposure patients had higher odds of being infected with subtype B. Where HIV-1 genotypes circulate within countries or patient risk-groups, local monitoring of genotype-specific transmissions may play a role in focusing public health prevention strategies. Phylogenetic evaluations provide complementary information for surveillance and monitoring of viruses with high mutation rates such as HIV-1 and Ebola.


Asia; CRF01_AE; HIV exposure; Subtype B

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