Transmission network and phylogenetic analysis highlight the role of
suburban population in HIV-1 transmission among older adults in Nanjing,
Jiangsu Province, China
Abstract
Description of the transmission characteristics among older adults is
helpful for the tailored interventions. Epidemiological investigation
combined with phylogenetic analysis were performed to reveal potential
transmission linkage among the older people in Nanjing. During
2018-2022, 188 pol sequences were successfully amplified.
Multiple genotypes were identified, including CRF07_BC (55.3%),
CRF01_AE (30.3%), CRF08_BC (8.0%), B (3.2%), CRF55_01B (1.1%),
CRF67_01B (0.5%),CRF68_01B (0.5%), and unique recombinant forms
(URF) (1.1%). Transmission network analysis found 120 genetically
linked patients forming 23 clusters (2-26 individuals). Multivariable
logistic regression analysis showed that compared with farmers and
heterosexuals, patients with other occupation (OR= 0.404, 95%
CI:0.173-0.945) and MSM (OR= 0.193, 95% CI:0.050-0.738) were less
likely to have high linkage. Subjects who lived in suburban places were
more likely to have high linkage (OR= 10.932, 95% CI:3.335-35.830). The
Sankey diagram suggested that patients who lived in suburban places
mainly transmitted the disease within the locally district (χ
2=24.192, P<0.001). Among 188 pol
segments, the prevalence of pretreatment drug resistance was 8%. In
suburban places with an increasing HIV-1 epidemic, there is a need to
improve early detection and timely treatment. More tailored
interventions for this subgroup are urgently needed.