Pretreatment HIV Drug Resistance toIntegrase Strand Transfer Inhibitors Among Newly Diagnosed HIV Individuals —China, 2018–2023
Hongping Hu1; Jingjing Hao1;Dong Wang1; Xiu Liu1; Hongli Chen1; FangyuanLi1; Jin Chen1; Miaomiao Li1; Peixian Xin1;Yantong Li1; Qi Li1; Huan Li1; Jialu Li1;Jing Hu1; Chang Song1; Yi Feng1; Lingjie Liao1;Yuhua Ruan1; Hui Xing1,#
1. State Key Laboratory of Infectious Disease Prevention and Control(SKLID), National Center for AIDS/STD Control and Prevention, Chinese Centerfor Disease Control and Prevention, Beijing, China.
# Corresponding author: Hui Xing, xingh@chinaaids.cn.
The widespread adoption ofintegrase strand transfer inhibitors (INSTIs) has led to the emergence ofINSTI-associated drug-resistance mutations. This cross-sectional studyconducted a comprehensive national survey to investigate the prevalence ofpretreatment drug resistance (PDR) to INSTIs among newly diagnosed HIVindividuals in China. The study enrolled 10,654 individuals from 31provincial-level administrative divisions between 2018 and 2023. Allparticipants underwent integrase region genotypic resistance testing. PDR toINSTIs was analyzed using the Stanford HIV drug resistance database, andmolecular transmission networks were constructed using HIV-TRACE. The overallPDR prevalence to INSTIs was 0.95%. The predominant major and accessorymutations identified were E138K/A (n=19) and G163R/K (n=29),respectively. Multivariable logistic regression analysis revealed that age ≥50years [adjusted odds ratio (aOR)=1.87, 95% confidence interval (CI): 1.03, 3.42] and HIV subtype B (aOR=3.87,95% CI: 1.97, 7.58) were significantrisk factors for PDR. Molecular network analysis showed that 1,257 (26.0%)CRF07_BC sequences formed 432 transmission clusters, while 811 (27.6%) CRF01_AEsequences were associated with 335 clusters. The identified drug-resistancemutations included E138K/A, R263K, Y143H, G163R/K, E157Q, and T97A. The currentprevalence of PDR to INSTIs in China remains low. However, given the increasingwidespread use of INSTIs, continuous surveillance of drug resistance emergenceand transmission patterns is essential.
新诊断HIV感染者对整合酶链转移抑制剂的治疗前耐药研究 — 中国,2018–2023年
胡红萍1;郝静静1;王栋1;刘秀1;陈宏利1;李方园1;陈金1;李苗苗1;辛沛贤1;李彦潼1;李淇1;李唤1;李佳璐1;胡婧1;宋畅1;冯毅1;廖玲洁1;阮玉华1;邢辉1,#
1. 传染病预防控制国家重点实验室,性病艾滋病预防控制中心,中国疾病预防控制中心,北京,中国。
# 通信作者:邢辉,xingh@chinaaids.cn。
整合酶链转移抑制剂(integrasestrand transfer inhibitors, INSTIs)的广泛使用导致了与INSTIs相关的耐药突变的出现。本研究是一项大规模的基于全国的横断面研究,以调查中国HIV新诊断感染者对INSTIs的治疗前耐药的流行情况及突变情况。本文共纳入2018 、2022、2023年间来自31个省级行政区划的10654人新诊断HIV感染者。对HIV感染者的整合酶基因区进行检测。利用斯坦福 HIV耐药数据库对INSTIs进行基因型耐药分析,并利用Tamura-Nei93模型和HIV- TRACE构建分子传播网络。本研究INSTIs治疗前耐药率为0.95%。检出频率最高的主要和次要耐药突变是E138K/A (n=19)和G163R/K (n=29)。多因素logistic回归模型显示,年龄≥50岁[aOR=1.87,95% (CI):1.03-3.42],HIV B亚型(aOR=3.87,95% CI:1.97-7.58)是INSTIs治疗前耐药相关的危险因素。分子网络结果显示,1257个(26.0%)CRF07_BC患者入网,形成432个分子传递簇;811个(27.6%)CRF01_AE患者节点入网,形成335个分子传递簇。入网的耐药突变位点为E138K/A、R263K、Y143H、G163R/K、E157Q和T97A。中国目前INSTIs类药物治疗前耐药率处于较低水平。随着INSTIs类药物的广泛使用,有必要持续监测耐药性的出现和流行情况。
For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2025.007
Characteristics and Predictors ofInterprovincial Migration Following HIV Diagnosis Among Men Who Have Sex withMen — China, 2016–2022
Duo Shan1;Yonghong Liu2; Chunpeng Zang1; Yuan Zhao1; HuiLi1; Jing Han1; Juan Yang1; Jiaye Liu3;Zhongfu Liu1; Yufen Liu1,#
1. NationalCenter for AIDS/STD Control and Prevention, Chinese Center for Disease Controland Prevention, Beijing, China;
2. BeijingCenter for Disease Prevention and Control, Beijing, China;
3. Schoolof Public Health, Shenzhen University Health Science Center, Shenzhen City,Guangdong Province, China.
# Corresponding author: Yufen Liu, yufenliu69@chinaaids.cn.
Men whohave sex with men (MSM) are a high-risk group for human immunodeficiency virus(HIV) infection and exhibit significant mobility characteristics. This studyaims to explore the interprovincial mobility patterns and predictors ofHIV-positive MSM in China between 2016 and 2022, providing evidence fortargeted case management in the future. Data from the National HIV/AIDSComprehensive Control and Prevention data system were utilized. Descriptiveanalysis and χ² tests were used to compare the characteristics of mobile versusnon-mobile cases after diagnosis. A chord diagram was drawn to visualizemobility patterns of HIV-positive MSM after diagnosis. Logistic regressionmodels were applied to analyze factors influencing post-diagnosis mobility.Statistical significance was defined as P<0.05. A total of 204,394HIV-positive MSM cases were included in the analysis, of which 20,117 (9.8%)exhibited interprovincial mobility. Mobile individuals were primarily young(36.4% aged 15–24), unmarried (71.1%), and had lower educational levels (60.8%with high school education or below). Mobility predominantly occurred fromeconomically developed areas (e.g., Guangdong, Shanghai) to less-developedregions (e.g., Sichuan, Anhui). The treatment rate among mobile individuals wassignificantly lower than that of non-mobile individuals (91.3% vs.95.0%, P<0.001), with 33.8% starting treatment after moving. Mobilityrates significantly declined from 2020 to 2022. This study reveals the mobilitypatterns and predictors of HIV-positive MSM after diagnosis, highlightingchallenges to case management and treatment continuity. Economically developedregions should consider relaxing medical reimbursement policies for non-localpatients and optimizing interprovincial case management processes. For mobilepopulations, strengthened service coordination between departure anddestination locations is essential to ensure timely treatment and preventiveinterventions, ultimately improving the health outcomes and quality of life ofthis vulnerable group.
HIV确诊后男男性行为人群跨省流动的特征及预测因素— 中国,2016–2022年
单多1;刘永红²;臧春鹏¹;赵媛¹;李慧¹;韩晶¹;杨娟¹;刘甲野³;刘中夫¹;刘玉芬1,#
1. 中国疾病预防控制中心性病艾滋病预防控制中心,北京,中国
2. 北京市疾病预防控制中心,北京,中国
3. 深圳大学医学部公共卫生学院,广东省深圳市,中国。
#通信作者:刘玉芬, yufenliu69@chinaaids.cn。
男男性行为人群(MSM)是感染人类免疫缺陷病毒(HIV)的高风险群体,并表现出显著的流动性特征。本研究旨在探讨2016-2022年期间我国HIV阳性男男性行为人群确诊后的省际流动特征及其预测因素,为今后实施有针对性的病例管理提供依据。利用全国艾滋病防治基本信息系统报告数据,采用描述性分析、χ2检验比较病例确诊后流动者与非流动者的特征,绘制弦图展示HIV阳性MSM确证后流动情况。病例确证后流动的影响因素分析采用logistic回归模型。以P<0.05为差异有统计学意义。研究期间,共204,394例HIV阳性MSM病例纳入分析,其中20,117名(9.8%)发生省际流动。流动者以年轻(36.4%为15-24岁)、未婚(71.1%)和教育水平较低(60.8%为高中及以下)者为主,主要从经济发达地区(如广东、上海)迁往经济欠发达地区(如四川、安徽)。流动人群治疗率显著低于非流动人群(91.3% vs. 95.0%,P<0.001),33.8%的流动者在流动后开始治疗。2020-2022年期间的流动率显著下降。本研究揭示了HIV确诊后MSM人群的流动特征及其预测因素,提示流动对病例管理和治疗连续性构成挑战。经济发达地区应适当放宽外地患者的医疗报销政策,并优化跨省病例管理流程。针对流动人群,应在迁出地和迁入地加强服务对接,确保及时治疗和预防干预,提升HIV阳性MSM这一脆弱群体的健康结局和生活质量。
For more information:https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2025.009
Associations of First-Year Low-LevelViremia with Subsequent Viral Non-Suppression in People Living with HIV onAntiretroviral Therapy — Dehong Dai and Jingpo Autonomous Prefecture, YunnanProvince, China, 2008–2021
Hailiang Yu1;Runhua Ye2; Dongdong Cao3; Yanfen Cao2; YunShi4; Guifang Xiao5; Pinyin Li6; Yanling Feng7;Hua Wei8; Jinting Sun9; Song Duan2; YuechengYang2, #;Cong Jin1, #
1.National Center for AIDS/STD Control and Prevention, Chinese Center for DiseaseControl and Prevention, Beijing, China;
2.Dehong Dai and Jingpo Autonomous Prefecture Center for Disease Control andPrevention, Dehong Prefecture, Yunnan Province, China;
3.Dehong Dai and Jingpo Autonomous Prefecture People's Hospital, DehongPrefecture, Yunnan Province, China;
4.Mangshi People’s Hospital, Dehong Dai and Jingpo Autonomous Prefecture, DehongPrefecture, Yunnan Province, China;
5.Traditional Chinese Medicine Hospital of Dehong Dai and Jingpo AutonomousPrefecture, Dehong Prefecture, Yunnan Province, China;
6.Ruili City People's Hospital of Dehong Dai and Jingpo Autonomous Prefecture,Dehong Prefecture, Yunnan Province, China;
7.Longchuan County People's Hospital of Dehong Dai and Jingpo AutonomousPrefecture, Dehong Prefecture, Yunnan Province, China;
8.Yingjiang County People's Hospital of Dehong Dai and Jingpo AutonomousPrefecture, Dehong Prefecture, Yunnan Province, China;
9.Lianghe County People's Hospital of Dehong Dai and Jingpo AutonomousPrefecture, Dehong Prefecture, Yunnan Province, China.
# Corresponding authors: Cong Jin, jinc@chinaaids.cn; Yuecheng Yang, yyc0605@126.com.
Human immunodeficiency virus (HIV) low-levelviremia (LLV) during antiretroviral therapy (ART) occurs frequently in DehongDai and Jingpo Autonomous Prefecture, Yunnan Province. Among people living withHIV who achieved virological success (viral load, VL <1,000 copies/mL) afterinitiating ART in Dehong Prefecture, Southwest China, 17.6% experiencedfirst-year LLV of 50–999 copies/ml. First-year LLV emerged as an independentrisk factor for subsequent viral non-suppression compared with participantsmaintaining first-year VL <50 copies/mL. Enhanced monitoring andinterventions for early LLV occurrence during the first year of ART areessential, including adherence education and timely VL testing.
接受抗逆转录病毒治疗达到病毒学成功的HIV感染者第1年发生低病毒血症与后续随访HIV病毒不抑制的关联 — 德宏傣族景颇族自治州,云南省,中国,2008–2021年
俞海亮1;叶润华2;曹东冬3;曹艳芬2;时允4;肖桂芳5;李品银6;冯艳玲7;魏华8;孙进挺9;段松2;杨跃诚2,#;金聪1,#
1. 中国疾病预防控制中心性病艾滋病预防控制中心,北京,中国;
2. 德宏傣族景颇族自治州疾病预防控制中心,德宏州,云南省,中国;
3. 德宏傣族景颇族自治州人民医院,德宏州,云南省,中国;
4. 德宏傣族景颇族自治州芒市人民医院,德宏州,云南省,中国;
5. 德宏傣族景颇族自治州中医医院,德宏州,云南省,中国;
6. 德宏傣族景颇族自治州瑞丽市人民医院,德宏州,云南省,中国;
7. 德宏傣族景颇族自治州陇川县人民医院,德宏州,云南省,中国;
8. 德宏傣族景颇族自治州盈江县人民医院,德宏州,云南省,中国;
9. 德宏傣族景颇族自治州梁河县人民医院,德宏州,云南省,中国。
# 通信作者:金聪,jinc@chinaaids.cn;杨跃诚,yyc0605@126.com。
身在云南省德宏傣族景颇族自治州,抗逆转录病毒治疗(ART)期间人类免疫缺陷病毒(HIV)低水平病毒血症(LLV)较为常见。在中国西南部的德宏州启动ART后获得病毒学成功(病毒载量,VL <1,000拷贝/ml)的HIV感染者中,有17.6%在ART的第1年内出现VL水平在50–999拷贝/ml的LLV。与第1年病毒载量维持在<50拷贝/ml的HIV感染者相比,第1年出现LLV成为后续VL未抑制的独立风险因素。在ART的第1年内,加强LLV的监测和干预至关重要,包括依从性教育和及时的病毒载量检测。
For more information:https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2025.010
Accuracy of the Self-Administered RapidHIV Urine Test in a Real-World Setting and Individual Preferences for HIVSelf-Testing — Guangzhou City, Guangdong Province, China, July 2020–February2021
Chunli Zhang1,&; Mengdie Li2,&;Yuzhou Gu3; Yongheng Lu4,5; Sha Chen6; ZhongqiLiu7; Yuantao Hao8,9,10,#; Chun Hao1,2,#
1. Department of MedicalStatistics, School of Public Health, Sun Yat-Sen University, Guangzhou City,Guangdong Province, China;
2. Sun Yat-Sen Global HealthInstitute, Institute of State Governance, Sun Yat-Sen University, GuangzhouCity, Guangdong Province, China;
3. Guangzhou Center forDisease Control and Prevention, Guangzhou City, Guangdong Province, China;
4. Guangzhou LingnanCommunity Support Center, Guangzhou City, Guangdong Province, China
5. Kangyuan Community SupportCenter of Yuexiu District, Guangzhou City, Guangdong Province, China;
6. West China Hospital ofSichuan University, Chengdu City, Sichuan Province, China
7. Department of QualityManagement Evaluation, The First Affiliated Hospital, Sun Yat-Sen University,Guangzhou City, Guangdong Province, China;
8. Peking University Centerfor Public Health and Epidemic Preparedness & Response, Beijing, China;
9. Department of Epidemiology& Biostatistics, School of Public Health, Peking University, Beijing, China;
10. Key Laboratory ofEpidemiology of Major Diseases (Peking University), Ministry of Education,Beijing, China.
& Joint first author
# Corresponding author: Chun Hao, haochun@mail.sysu.edu.cn;Yuantao Hao, haoyt@bjmu.edu.cn.
human immunodeficiency virus (HIV)self-testing serves as a crucial strategy for overcoming testing barriers, withurine-based self-testing emerging as a potential novel approach. In areal-world setting, this study demonstrated that the urine rapid test exhibitedlower diagnostic accuracy compared to the blood rapid test. Study participantsexpressed stronger preferences for HIV self-testing methods utilizing fingerprick samples, accompanied by standard written instructions and lower costs. Ourfindings indicate that rapid urine testing requires additional validationbefore widespread implementation. Future development efforts should prioritizeuser-friendly HIV self-testing approaches to enhance testing accessibility.
真实世界环境中自行操作的艾滋病病毒快速尿液检测的准确性以及艾滋病病毒自我检测的个人偏好— 广州市,广东省,中国,2020年7月–2021年2月
张春丽1&;李梦碟2&;古羽舟3;鲁永恒4,5;陈莎6;刘仲琦7;郝元涛8,9,10#;郝春1,2#
1. 中山大学公共卫生学院医学统计学系,广州市,广东省,中国;
2. 中山大学国家治理研究院全球卫生研究中心,广州市,广东省,中国;
3. 广州市疾病预防控制中心,广州市,广东省,中国;
4. 广州岭南社区支持中心,广州市,广东省,中国;
5. 广州市越秀区康源社区支持中心,广州市,广东省,中国;
6. 四川大学华西医院,成都市,四川省,中国;
7. 中山大学附属第一医院质量管理评价处,广州市,广东省,中国;
8. 北京大学公众健康与重大疫情防控战略研究中心,北京,中国;
9. 北京大学公共卫生学院流行病与卫生统计学系,北京,中国;
10. 北京大学重大疾病流行病学教育部重点实验室,北京,中国。
&共同第一作者
#通信作者:郝春,haochun@mail.sysu.edu.cn; 郝元涛,haoyt@bjmu.edu.cn。
人类免疫缺陷病毒(HIV)自我检测是克服检测障碍的一项关键策略,而基于尿液的自我检测已成为一种潜在的新型检测途径。这项研究表明,在真实世界环境中尿液快速检测相较于血液快速检测呈现出更低的诊断准确性。研究参与者更倾向于采用指尖采血样本的艾滋病病毒自我检测方法,并且希望配有标准的书面使用说明以及更低的检测成本。我们的研究结果显示,在广泛推行尿液快速检测之前,还需要对其进行进一步的验证。未来的研发工作应优先考虑便于使用的艾滋病病毒自我检测方法,以提高检测的可及性。
For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2025.011
Synergizing Digital and PhysicalApproaches: Experience Summary of the HIV PrEP Promotion Project
Shuyu Wang1; Wenting Kang2;Jingkun Hu1; Dapeng Zhang1; Jie Xu1; HoulinTang1; Junjie Wang1; Fan Lyu1; Guang Zhang1,#
1. NationalCenter for AIDS/STD Control and Prevention, Chinese Center for Disease Controland Prevention, Beijing, China.
2. ChineseAssociation of STD&AIDS Prevention and Control, Beijing, China.
#Corresponding author: Guang Zhang, zhangguang2000@chinaaids.cn.
China's HIV/AIDSprevention and control efforts have entered a new stage, necessitating theexploration of more effective intervention strategies. HIV pre-exposureprophylaxis (PrEP) is a proven method to prevent HIV infection, but itspromotion in China faces challenges such as low public acceptance andinadequate service capacity. To further promote PrEP, the "HIV PrEP ModelExploration Project" was launched, exploring three PrEP service models:PrEP clinics, Digital services and physical testing and PrEP self-servicevending machines. The project achieved certain results, establishing a PrEPservice network, training professional staff, and promoting the use of PrEP. Inthe future, it is necessary to further expand publicity channels, enhancepublic awareness and acceptance, optimize follow-up management, and promote thepopularization of PrEP and HIV/AIDS prevention and control efforts.
协同线上和线下方法:艾滋病毒预防推广项目的经验总结
王淑瑜1;康文婷2;胡景坤1;张大鹏1;徐杰1;汤后林1;王俊杰1;吕繁1;张广1,#
1. 中国疾病预防控制中心性病艾滋病预防控制中心,北京,中国;
2. 中国性病艾滋病防治协会,北京,中国。
#通信作者:张广,zhangguang2000@chinaaids.cn。
我国的艾滋病防治工作已经进入了一个新的阶段,需要探索更有效的干预策略。艾滋病毒暴露前预防(pre-exposure prophylaxis, PrEP)是一种已被证实的预防艾滋病毒感染的方法,但其在中国的推广面临着公众接受度低和服务能力不足等挑战。为进一步推广PrEP,启动了“艾滋病毒PrEP模式探索项目”,探索了三种PrEP服务模式: PrEP诊所、线上服务、线下检测和PrEP自助自动售货机。项目取得了一定的效果,建立了预防服务服务网络,培训了专业人员,推广了预防服务。今后,需要进一步扩大宣传渠道,提高公众意识和接受度,优化后续管理,促进预防和艾滋病防治工作的普及。
For more information: https://weekly.chinacdc.cn/en/article/doi/10.46234/ccdcw2025.012