Near Full-Length Genome Characterization of an HIV-1 CRF01_AE Strain in Jiangsu, China: Evidence of Two Independent Introductions from Fujian

The occurrence of a novel CRF01_AE-associated recombinant in Jiangsu implies the importance of characterizing full-length CRF01_AE genomic sequence from injecting drug users (IDUs). Here, we reported a near full-length CRF01_AE sequence 07JSWX045 obtained from a Jiangsu IDU, using a modified method. The sequence analyses of 07JSWX045 revealed several interesting findings. First, 07JSWX045 was phylogenetically close to CRF01_AE strains circulating among Jiangsu men who have sex with men (MSM), implying a recent common ancestor. Second, 07JSWX045 was not genetically associated with the CRF01_AE part of the new CRF01_AE/07_BC recombinant found in Jiangsu. Third, both 07JSWX045 and the CRF01_AE parent of CRF01/07 recombinant phylogenetically clustered with two different CRF01_AE subgroups circulating in Fujian, respectively. It suggests that at least two genetically independent CRF01_AE descendants are circulating in Jiangsu possibly via two independent introductions from Fujian. Fourth, two AZT resistance mutations in the RT gene were detected within patient JSWX045, who did not receive any antiviral therapy before sampling, providing valuable bioinformatics sites for investigating the epidemic origin and molecular properties of Jiangsu CRF01_AE strains. Furthermore, patient JSWX045 had two high-risk behaviors including injection drug use and heterosexual contact. He might have been initially infected with CRF01_AE via heterosexual contact, and then introduced this subtype to other people via injection drug use. Therefore, increasing concern is urgently needed for those persons who often have more than two high-risk behaviors.