Emerging HIV infections with distinct subtypes of HIV-1 infection among injection drug users from geographically separate locations in Guangxi province, China

Xiao Fang Yu, Jie Chen, Yiming Shao, Christopher Beyrer, Bindong Liu, Zhe Wang, Wei Liu, Jinye Yang, Shaoling Liang, Raphael P Viscidi, Jing Gu, Gregory Gurri-Glass, Shenghan Lai

Research output: Contribution to journalArticle


Heroin users from Guangxi province, a southern province of China that borders Vietnam in the south and Yunnan province in China in the west, were studied for prevalence and risk factors for HIV-1 infection. Viral env sequences from HIV-1-positive individuals were also determined for subtypes of HIV-1. The overall HIV prevalence among 227 heroin users was 40%. Most had used drugs for ≤3 years. Sharing of injection equipment and unprotected sex were significantly associated with HIV-1 infection. Subtypes C and E HIV-1 were detected in infected heroin users and were sharply segregated in two geographic locations: only subtype C was found in a border city with Yunnan province, whereas only subtype E was found in a city bordering northern Vietnam. HIV-1 strains within each subtype were remarkably homogenous, with a mean intersubject DNA distance of 2.32% for subtype E and 1.13% for subtype C, respectively. Phylogenetic analysis of C2-V5 region of Guangxi subtype E env sequences revealed significant clustering with subtype E sequences from southern Vietnam and Cambodia. These results suggest that HIV-1 infection among heroin users in Guangxi represents two emerging epidemics initiated from distinct sources: one from Vietnam and another from Yunnan province. Factors associated with HIV-1 infection were not restricted to injection practices. Unprotected sexual behaviors are likely to increase the probability of HIV transmission beyond this high-risk population. Designing and implementing effective intervention strategies targeted toward both injection drug use and high risk sexual behavior are urgently needed to further reduce HIV-1 spread in China.

Original languageEnglish (US)
Pages (from-to)180-188
Number of pages9
JournalJournal of Acquired Immune Deficiency Syndromes and Human Retrovirology
Issue number2
StatePublished - Oct 1 1999



  • China
  • HIV-1
  • IDU
  • Subtypes

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology
  • Virology

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