Molecular epidemiology of HIV and the genetic factors influencing AIDS disease progression in Asia

（1）亚洲HIV的分子流行病学：我们在亚洲的几个研究地点调查了HIV的分子流行病学，以阐明流行病与周边地区和不同风险人群的相互关系。在中国，我们发现IDU/既往献血浆者（FPD）和异性恋者之间的流行密切相关。特别是，HIV-1亚型B，在中国中部造成悲剧性爆发的毒株，被发现在异性恋者中占主导地位。这就迫切需要采取有效的措施来预防HIV-1在中国的传播。随着时间的推移，HIV-1命名系统变得非常复杂。一个主要的HIV-1株，HIV-1 M组，负责目前的大流行，至少有11个亚型和亚型和34个循环重组形式（CRF）的分类。我们在马来西亚的IDU和异性恋者中确定了第33个CRF（CRF33_01B）。这是日本一个研究小组报告的第一个被国际HIV序列数据库正式批准的CRF。（2）影响疾病进展为AIDS的病毒和宿主因素的调查：疾病进展为AIDS的速度受到以下几个因素的极大影响：最重要的是病毒和宿主因素。我们首次在亚洲的一名长期无进展者中发现了CRF01_AE感染伴nef-LTR区域严重缺失的病例。这是在非亚型B毒株中发现的第一例nef-LTR缺失，与较慢的疾病进展有关。对于宿主因素，Shioda博士和他的同事在泰国进行的研究中证实了IL 4 - 589 T和RANTES-28 G对HV疾病进展具有显著的保护作用。这些发现可以为了解亚洲HIV/AIDS流行的起源以及未来预防HIV在亚洲传播的疫苗策略提供关键信息。

(1)Molecular epidemiology of HIV in Asia :We investigated the molecular epidemiology of HIV in several study sites in Asia to elucidate the interrelationships of the epidemics with those of surrounding regions and of different risk populations. In China, we found the close Interrelationships of the epidemics between IDU/former plasma donor (FPD) and heterosexuals. In particular, HIV-1 subtype B, the strain responsible for the tragic outbreaks In central China, is found to predominate among heterosexuals. This urges the urgent need for implementation of effective measures to prevention the Infections into general population in China.HIV-1 nomenclature system is becoming very complicated as the time goes by. A major HIV-1 strain, HIV-1 group M, responsible for the current pandemic is classified at least 11 subtypes and subsubtypes and 34 circulating recombinant forms (CRFs) so far. We identified the 33rd CRF (CRF33_01B) among IDU and heterosexuals in Malaysia. This is the first CRF reported from a research group in Japan that was officially approved by international HIV sequence databases.(2)Investigation of virus and host factors influencing the disease progression to AIDS :The rate of disease progression to AIDS is influenced greatly by several factors : most Importantly viral and host factors. We for the first time identified the case of CRF01_AE infection with gross deletions in nef-LTR regions among a long-term nonprogressor in Asia. This is the first case of nef-LTR deletion found among nonsubtype B strains, associated with slower disease progression. For the host factors, Dr.Shioda and his colleagues confirmed the significant protective effect of IL4-589T and RANTES-28G on HV disease progression in their study conducted in Thailand.These findings could provide the information critical for understanding the genesis of HIV/AIDS epidemic in Asia and for the future vaccine strategies to prevent HIV spread in Asia.