Spatiotemporal Origin and Cross-Regional Transmission Dynamics of HIV-1 Circulating Recombinant Form (CRF85_BC) in Developed Eastern China: A Seven-Year Comprehensive Molecular Surveillance Study - Scorecard - MDSpire
Clinical Scorecard: Geographic and Temporal Origins and Spread of HIV-1 CRF85_BC Across Developed Eastern China: Findings from Seven Years of Molecular Surveillance
At a Glance
Category
Detail
Condition
HIV-1 infection with the circulating recombinant form CRF85_BC
Key Mechanisms
CRF85_BC is a B/C chimeric recombinant with breakpoints across the pol and env regions; the study examines its introduction, local transmission, and geographic spread.
Target Population
Newly diagnosed HIV-1-infected individuals in Zhejiang Province, China, with CRF85_BC infection and eligible epidemiological data and sequence quality.
Care Setting
Province-wide HIV molecular surveillance in Zhejiang, eastern China, from 2017 through 2023.
Key Highlights
This retrospective, population-based study analyzed 259 people with CRF85_BC infection identified from 2017 through 2023.
CRF85_BC was detected in Zhejiang in 2017 and had reached all 11 prefecture-level cities by 2023, becoming the province’s fifth most prevalent HIV-1 subtype.
Phylogeographic analysis indicated repeated introductions from Sichuan and Yunnan, followed by sustained transmission within Zhejiang centered on Jiaxing.
Molecular network analysis identified 183 people (70.66%) in 41 clusters. Jiaxing accounted for 48.63% of clustered cases; 58.60% of genetic linkages connected two Jiaxing cases.
Guideline-Based Recommendations
The article presents surveillance findings and the authors’ public health recommendations rather than a clinical practice guideline.
Diagnosis
Surveillance combined laboratory-confirmed HIV diagnoses with epidemiological information and qualifying HIV-1 pol sequences.
Preliminary subtyping used COMET, followed by confirmation using maximum-likelihood phylogenetic analysis and the Los Alamos National Laboratory HIV BLAST tool.
Management
The authors recommend strengthening antiretroviral therapy management to maintain viral suppression in core transmission clusters.
They also recommend targeted partner notification and promotion of preexposure prophylaxis to interrupt ongoing transmission.
Monitoring & Follow-up
The findings support routine provincial molecular surveillance and cross-provincial collaborative monitoring.
Linking sequence data with demographic, geographic, and transmission-route information can help identify affected populations and core clusters.
Risks
Heterosexual contact accounted for 241/259 infections (93.05%).
Adults aged 60 years or older had higher clustering before adjustment, but age was not independently associated with clustering after adjustment.
Nonlocal household registration remained independently associated with lower clustering odds.
Several members of the four large clusters had detectable viremia despite recorded antiretroviral therapy, indicating a need for improved viral suppression.
Patient & Prescribing Data
The cohort included 259 newly diagnosed individuals: 181 (69.88%) were male, 191 (73.75%) were aged 50 years or older, and 115 (44.40%) were aged 60 years or older. Permanent Zhejiang residents accounted for 122 cases (47.10%); 137 (52.90%) had nonlocal household registration.
The study was not a treatment trial. It reported treatment-status and viral-load information for members of the four large clusters, including detectable viremia in some individuals with recorded antiretroviral therapy. It did not establish a CRF85_BC-specific prescribing regimen.
Clinical Best Practices
Apply standardized sequence-quality criteria and subtype verification in molecular surveillance.
Combine molecular findings with demographic and geographic information when prioritizing public health responses.
Interpret older adults’ higher clustering alongside residence and other population characteristics.
Recognize the study’s limitations: analysis of the pol region alone, possible selection bias from undiagnosed infections and sequencing failures, and absence of individual-level behavioral survey data.
Avoid interpreting the observed clustering rate as proof of greater intrinsic transmissibility; the authors could not distinguish viral properties from population network structure.
Related Resources & Content
Spatiotemporal origin and cross-regional transmission dynamics of HIV-1 circulating recombinant form (CRF85_BC) in developed eastern China: a 7-year comprehensive molecular surveillance study — Qin Fan, Jiafeng Zhang, Jun Jiang, et al. — International Journal of Infectious Diseases. 2026;173:109207. doi:10.1016/j.ijid.2026.109207.
Identification of a novel HIV-1 circulating recombinant form (CRF85_BC) in Sichuan, China — Su L, Wei D, Yang H, et al. — AIDS Research and Human Retroviruses. 2016;32(9):895–899. doi:10.1089/aid.2016.0053.
Rapid circulation of HIV-1 CRF85_BC in Southwest China: its geographic origins and molecular transmission networks analysis — Liu Y, Yang C, Chang W, et al. — Frontiers in Cellular and Infection Microbiology. 2025;15:1624996. doi:10.3389/fcimb.2025.1624996.
