16. Outbreak of HIV-1 and HCV Infection among Illegal Blood Donors in China

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Session 5 Oral Abstract Session
Epidemiology and Infection Control
Session Time: Monday, 10 am - 12:30 pm
Room 6C

11:15 16.

Outbreak of HIV-1 and HCV Infection among Illegal Blood Donors in China
L. Zhang*¹, Y. Cao², J. Yu¹, T. He¹, W. Yu¹, Z. Chen¹, N. Yin², S. Mei², Z. Zhou², Y. He², W. Lu², Z. Chen¹, and D. Ho¹
¹ Aaron Diamond AIDS Res. Ctr., Rockefeller Univ., New York, NY and ²Natl. Ctr. for AIDS Prevention and Control, Chinese Academy of Preventive Med., Beijing

Background: HIV-1 infection rates in China are increasing at an alarming rate of 30% per year. In border provinces, such as Yunnan and Xinjiang, the epidemic is primarily seen in intravenous drug users and their sexual contacts. Recently, HIV-1 infections linked to illegal blood donations have been well publicized, particularly in the central province of Henan.
Methods: To investigate strains of HIV-1 and HCV currently circulating in these high-risk groups and to monitor their pattern of dissemination, we have undertaken a systematic molecular epidemiologic study of viral genotypes in these 3 provinces.
Results: Among a total of 239 HIV-1-infected individuals studied, 62% were infected via blood contamination, directly related to either illegal blood donation or intravenous drug use. The other 36% were sexual contacts of high-risk individuals. About 1% occurred as the result of maternal-fetal transmission. In addition, 57% of these 239 individuals were also co-infected with HCV, of which 96% were found in either illegal blood donors or intravenous drug users. Genetic characterization of the viral sequences (C2V3 region for HIV-1 and 5'NCR for HCV) indicates that the illegal blood donors in Henan harbor HIV-1 subtype B and HCV genotypes 1 and 2, whereas those intravenous drug users in Xinjiang and Yunnan carry HIV-1 subtype C and HCV genotypes 1, 3, and 4. Furthermore, viruses within each of these 2 high-risk groups are relatively homogenous (on average 10% for HIV-1 C2V3 region and 2% for HCV 5'NCR region) and phylogenetically linked, suggesting recent but separate outbreaks of HIV-1 and HCV infection.
Conclusions: In conclusion, our findings show that the epidemics of HIV-1 and HCV infection in China are the consequences of multiple introductions. The distinct distribution patterns of HIV-1 and HCV genotypes in different high-risk groups are tightly linked to the mode of transmission rather than geographic proximity. Our findings should compel health care workers and government officials to implement necessary preventive measures to prevent the further dissemination of these viruses in the world's most populous nation.

Š2002 9^th Conference on Retroviruses and Opportunistic Infections