Comparative Circulation Dynamics of the Five Main HIV Types in China
Comparative Circulation Dynamics of the Five Main HIV Types in China
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DOI：
10.1128/jvi.00683-20
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发表时间：
2020-12-01
影响因子：
5.4
通讯作者：
Chaillon, Antoine
中科院分区：
文献类型：
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作者：
Vrancken, Bram;Zhao, Bin;Chaillon, Antoine
中国的艾滋病疫情占全球艾滋病发病率的3%。我们比较了五种最流行的流行类型的省际传播的模式和决定因素。在中国各地采样的HIV pol序列用于确定中国5种最相关的HIV-1型（B和循环重组型[CRF] CRF 01_AE、CRF 07_BC、CRF 08_BC和CRF 55_01 B）的相关传播网络。由此推断出其跨省传播的历史。一个广义线性模型（GLM）被用来测试各省之间的迁移率和人口流动的几个措施之间的关联。2004年至2017年期间，在26个省份共收集了10，707个序列，其中1，962个是新报告的。平均18个（最小和最大，1和54）独立的传输网络，涉及多达17个省被确定。离散的地理分析在很大程度上概括了记录在案的艾滋病毒类型的传播，这反过来又在很大程度上反映了中国境内的人口流动。根据不同的时空传播动态，其确定的驱动因素也是异质的，但与人类流动的核心作用是一致的。在中国传播的五种主要类型的艾滋病毒的传播动态的比较分析表明，大型人口中心和发达的交通基础设施作为艾滋病毒传播的枢纽的关键作用。重要性虽然传统的流行病学研究对描述流行病的动态非常感兴趣，但它们很难完全捕捉地理空间动态和驱动艾滋病毒等病原体传播的因素，因为它们很难捕捉感染之间的联系。为了克服这一点，我们使用了一个离散的非线性地理方法，结合广义线性模型扩展来描述在中国传播的五种主要HIV类型的跨省传播的动态和驱动因素。我们的研究结果表明，人口密集的大城市化地区和发达的交通基础设施是艾滋病毒在中国传播的促进因素，并强调需要考虑协调全国范围内的公共政策，以控制当地的艾滋病毒流行。
The HIV epidemic in China accounts for 3% of the global HIV incidence. We compared the patterns and determinants of interprovincial spread of the five most prevalent circulating types. HIV pol sequences sampled across China were used to identify relevant transmission networks of the five most relevant HIV-1 types (B and circulating recombinant forms [CRFs] CRF01_AE, CRF07_BC, CRF08_BC, and CRF55_01B) in China. From these, the dispersal history across provinces was inferred. A generalized linear model (GLM) was used to test the association between migration rates among provinces and several measures of human mobility. A total of 10,707 sequences were collected between 2004 and 2017 across 26 provinces, among which 1,962 are newly reported here. A mean of 18 (minimum and maximum, 1 and 54) independent transmission networks involving up to 17 provinces were identified. Discrete phylogeographic analysis largely recapitulates the documented spread of the HIV types, which in turn, mirrors within-China population migration flows to a large extent. In line with the different spatiotemporal spread dynamics, the identified drivers thereof were also heterogeneous but are consistent with a central role of human mobility. The comparative analysis of the dispersal dynamics of the five main HIV types circulating in China suggests a key role of large population centers and developed transportation infrastructures as hubs of HIV dispersal. This advocates for coordinated public health efforts in addition to local targeted interventions.IMPORTANCE While traditional epidemiological studies are of great interest in describing the dynamics of epidemics, they struggle to fully capture the geospatial dynamics and factors driving the dispersal of pathogens like HIV as they have difficulties capturing linkages between infections. To overcome this, we used a discrete phylogeographic approach coupled to a generalized linear model extension to characterize the dynamics and drivers of the across-province spread of the five main HIV types circulating in China. Our results indicate that large urbanized areas with dense populations and developed transportation infrastructures are facilitators of HIV dispersal throughout China and highlight the need to consider harmonized country-wide public policies to control local HIV epidemics.