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Brief Report

Onward Transmission of Multiple HIV-1 Unique Recombinant Forms Among Men Who Have Sex With Men in Beijing, China

Liu, Yongjian, PhDa; Su, Bin, PhDb; Zhang, Yu, BMa; Jia, Lei, PhDa; Li, Hanping, PhDa; Li, Zhen, PhDb; Han, Jingwan, PhDa; Zhang, Tong, MDb; Li, Tianyi, PhDa; Wu, Hao, MDb; Wang, Xiaolin, MPHa; Li, Jingyun, PhDa; Li, Lin, PhDa

JAIDS Journal of Acquired Immune Deficiency Syndromes: May 1, 2019 - Volume 81 - Issue 1 - p 1–4
doi: 10.1097/QAI.0000000000001983

Background: Unique recombinant forms (URFs) were generated in dually infected or multiply infected individuals, and some of URFs can be transmitted to many people resulting in the emergence of circulating recombinant forms (CRFs). We examined whether there was evidence for onward transmission of multiple URFs among men who have sex with men (MSM) in Beijing.

Methods: A total of 146 MSM subjects with acute/early HIV-1 infection were recruited from the Beijing PRIMO clinical cohort between September 2010 and July 2012. HIV-1 full-length gag and partial pol, env genes were amplified and sequenced separately. Phylogenetic analysis and recombination analysis were performed to determine the viral genotypes. Single genome amplification and direct sequencing were used to confirm onward transmission of URFs.

Results: CRF01_AE was the most common genotype (51.9%), followed by CRF07_BC (23.0%), subtype B (14.8%), URFs (7.4%), CRF65_cpx (2.2%), and CRF55_01B (0.7%). Multiple forms of URFs were identified, including CRF01_AE/BC, CRF01_AE/B, and CRF01_AE/C. Nine of the 10 individuals harboring URFs were infected by onward transmission of URFs. The remaining one individual was coinfected with CRF01_AE and CRF07_BC variants.

Conclusions: We introduced a new method to provide evidence for onward transmission of URF strains by examining the absence of intersubtype coinfection among early infected individuals. Onward transmission of multiple URFs was found among MSM in Beijing, China. Our findings call for a program of continuous molecular surveillance and have implications to prevention programs among MSM in China.

aDepartment of AIDS Research, State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China; and

bBeijing Key Laboratory for HIV/AIDS Research, Center for Infectious Diseases, Beijing You'an Hospital, Capital Medical University, Beijing, China.

Correspondence to: Lin Li, PhD, Department of AIDS Research, State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, No. 20 Dongda Street, Fengtai District, Beijing 100071, China (e-mail:

Supported by the NSFC (81773493), Beijing Municipal S&T Project (D141100000314001), Grant 2017YFC1200800, the State Key Laboratory of Pathogen and Biosecurity (AMMS), and the Beijing Key Laboratory for HIV/AIDS Research (BZ0089).

The authors have no funding or conflicts of interest to disclose.

Y.L. and B.S. contributed equally to the work.

Received August 13, 2018

Accepted January 04, 2019

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