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Emergence of two novel HIV-1 Circulating Recombinant Forms (CRF190_0708 and CRF191_0708): molecular characterization and clinical insights from a five-year study in Yunnan, China.

Li Gao·Wei Chang·Yuanlu Shu·Yang Liu·Mi Zhang·Qian Yang·Jianjian Li·HongYe Pai·Lingling Huang·Yongjiao Chen·Zhiqing Yang·Fei Lu·Xingqi Dong·Yue Feng·Xueshan Xia
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Abstract

BACKGROUND: To characterize HIV-1 molecular epidemiology and identify novel circulating recombinant forms (CRFs) among antiretroviral therapy (ART)-naïve heterosexuals in Yunnan, China, and evaluate their clinical impact. METHODS: This study examined 636 HIV-1 pol sequences to analyze genetic diversity, pretreatment drug resistance (PDR), and transmission networks. Near full-length genomes were obtained to identify and characterize novel recombinants, with their evolutionary history inferred by Bayesian analysis. Co-receptor tropism was predicted, and the five-year clinical outcomes (including immune reconstitution and virologic response) of patients infected with the novel CRFs were compared. RESULTS: The most prevalent type identified was CRF08_BC, accounting for 50.16% of cases. The prevalence of drug resistance was 5.97% (38/636), with the K103N mutation being the most common. An analysis of transmission networks revealed that 52.2% (272/521) of clusters were associated with CRF07_BC and CRF08_BC. Two novel second-generation CRFs were identified: CRF190_0708, with an estimated time to the most recent common ancestor (tMRCA) of 1998.9, and CRF191_0708, with a more recent tMRCA ranging from 2009.5 to 2011.6. During the five-year follow-up period, viral rebound was observed in 7 patients in the CRF190_0708 group and in 1 patient in the CRF191_0708 group. Drug-resistance mutations (M184V and K103N) were detected in a subset of rebound cases in the CRF190_0708 group. CONCLUSIONS: This study identifies two novel HIV-1 recombinants, CRF190_0708 and CRF191_0708, highlighting ongoing viral evolution in Yunnan. Preliminary findings suggest possible clinical differences, warranting further investigation. Continued molecular surveillance is needed. TRIAL REGISTRATION: The clinical study was registered at ClinicalTrials.gov under the identifier NCT03852849. The date of registration was March 22, 2019.

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AdultFemaleHumansMaleMiddle AgedChinaDrug Resistance, ViralEvolution, MolecularGenetic VariationGenome, ViralGenotypeHIV InfectionsHIV-1Molecular EpidemiologyPhylogenyRecombination, GeneticARTCRFNear full-length genomeYunnanJournal ArticleMulticenter StudyRandomized Controlled Trial

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Li Gao, Wei Chang, Yuanlu Shu, Yang Liu, Mi Zhang, Qian Yang, Jianjian Li, HongYe Pai, Lingling Huang, Yongjiao Chen, Zhiqing Yang, Fei Lu, Xingqi Dong, Yue Feng, Xueshan Xia. 2026-06-23. Emergence of two novel HIV-1 Circulating Recombinant Forms (CRF190_0708 and CRF191_0708): molecular characterization and clinical insights from a five-year study in Yunnan, China.. https://doi.org/10.1186/s12866-026-05323-x

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