Molecular transmission network reveals CRF08_BC-driven clusters of HIV-1 among low-education older adults linked to female sex workers in Taizhou, China

作者：Junxiao Lin, Xiaolu Wang, 王红宁, Shanling Wang, Guixia Li, Yi Jiang, T T Wang, Yali Xie, Yating Wang, Jiafeng Zhang, Haijiang Lin · 发表于：Frontiers in Microbiology · 年份：2026 · DOI：10.3389/fmicb.2026.1853569 · 研究领域：HIV Research and Treatment、HIV/AIDS Research and Interventions、HIV-related health complications and treatments

Background: The demographic structure of China's HIV-1 epidemic is rapidly shifting toward an aging population. This study aims to analyze the molecular transmission network characteristics of newly diagnosed HIV-1 infected individuals aged 50 and above in Taizhou, China, by combining sociodemographic information. Methods: Plasma samples were collected from newly diagnosed HIV-1 patients aged ≥50 years who were not receiving antiretroviral therapy (ART) in Taizhou between 2023 and 2025. HIV-1 subtypes were determined and pairwise genetic distances were calculated based on the HIV-1 pol gene sequences amplified by nested PCR and sequenced by Sanger sequencing. A molecular transmission network was constructed using a genetic distance threshold of 0.010. Logistic regression was subsequently used to identify factors associated with molecular clustering. Results: Of the 506 samples, 473 (93.5%) were successfully sequenced. The predominant HIV-1 subtypes identified were CRF07_BC (34.0%), CRF08_BC (33.8%), and CRF01_AE (23.5%). Univariate analysis showed that molecular clustering was associated with marital status, education level, heterosexual transmission, and viral subtype. Subsequent multivariate analysis revealed that clustering was significantly correlated with heterosexual contact (aOR = 2.71, 95%CI: 1.46-5.25) and infection with either the CRF08_BC (aOR = 5.90, 95%CI: 3.39-10.46) or CRF07_BC (aOR = 1.85, 95%CI: 1.10-3.14) subtypes. Overall, 264 cases (55.8%) formed 64 distin...