2010~2012年广西壮族自治区HIV-1流行株pol基因亚型的分布情况

Distribution of subtypes of pol gene in HIV-1 epidemic strains in Guangxi Zhuang Autonomous Region, 2010-2012

目的分析广西壮族自治区（广西）HIV-1流行株poz基因亚型的分布情况。方法于2010年1月1日至2012年12月31日，采用方便抽样的方法，在广西11个城市开展调查，通过问卷调查收集调查对象的流行病学资料。纳入标准为：Westernblot确证HIV-1阳性、病毒载量〉1000拷贝／ml、〉18岁及无特殊重大疾病。共招募到调查对象152例。采集每例调查对象5ml外周血并提取病毒基因组RNA，采用巢式RT—PCR扩增病毒pol区全长基因并测序；对所得序列修正后用Genotyping进行初步分型；采用MEGA5．03软件构建系统进化树对pol序列分型进行验证；采用RIP及jpHMMatGOBICS程序分析未知重组毒株的重组断点。结果152例HIV-1感染者共成功扩增出137例pof区全长基因，共获得127例HIV一1亚型判定，其中CRF01_AE占55．9％（71例），CRF08-BC占29．9％（38例），CRF07-BC占10．2％（13例），B（B’）占2．4％（3例），未知重组型占1．6％（2例）。广西11个城市以CRF01-AE亚型流行为主；异性性传播和注射毒品传播感染HIV-1者间CRF01_AE亚型分布差异有统计学意义（X2=15．07，P〈O．001），其比例分别为67．4％（58／86）和34．1％（14／41）；21～35、36～60和〉60岁HIV．1感染者中，CRF01_AE亚型所占比例分别为43．6％（17／39）、57．6％（38／66）、77．3％（17／22），CRF_08BC亚型所占比例分别为43．6％（17／39）、28．8％（19／66）、9．1％（2／22），差异有统计学意义（X2=8．48，P=0．014）。2株未知重组型毒株的模式分别为CRF01_AE／B（B’）和CRF01_AE／C／B（B’）重组型。结论2010--2012年广西HIV-1流行株pol基因主要流行亚型为CRF01_AE，以异性性传播为主；出现的未知重组型毒株是由CRF01_AE与CRF_BC重组产生的。

Objective To investigate the distribution and proportion of subtypes of pol gene in HIV-I epidemic strains in Guangxi Autonomous Region. Methods 152 HIV-1 patients were enrolled from 11 cities in Guangxi Autonomous Region from 2010 to 2012 by convenient sampling. Inclusion criterias were listed as the fdlowing： HIV-1 infection was confirmed by Western blot, HIV-1 viral load 〉1 000 copies/ml, 〉 18 year-old, and without any serious illnesses. 5 ml of peripheral blood samples were obtained from each patient. The viral RNA was isolated from plasma and used for amplification of full-length pol gene by nested RT-PCR. The amplified products were sequenced. After editing and modification, all sequences were characterized for preliminary subtyping by genotyping and confirmed with phylogenetic tree constructed by MEGA 5.03 software. The recombinant identification of 2 unknown recombinant strains was determined by RIP and jpHMM at GOBICS. Results Among 152 patients, 137 full-length pol genes were successfully amplified and 127 HIV-1 subtypes were identified. The distribution and proportion of subtypes was summarized as the following 71 cases of CRFOI_AE, accounting for 55.9% （71/127）, 38 CRFO8_BC, 29.9% （38/127）, 13 CRF07_BC, 10.2% （13/127）, and 3 B （B＇）, 2.4% （3/127）, 2 unknown recombinant strains, 1.6% （2/127）. In 11 cites of Guangxi Autonomous Region, subtype CRF01_AE was the dominant strain. Among heterosexual transmitted patients and drug abusers, the proportions of subtype CRF01_AE were 67.4% （58/ 86） and 34.1% （14/gl）, respectively. There was a significance different in the distribution of CRF01_AE in different routes of transmission （X2=15.07, P〈0.001）. In age 21-35, age 36-60 and age〉60 groups, the proportions of CRF01_AE was 43.6% （17/39）, 57.6% （38/66）, 77.3% （17/22）, and CRFO8_BC was 43.6% （17/39）, 28.8% （19/66）, 9.1% （2/22）, respectively, the difference in proportions was significant（~2=8.48, P= 0.014）. The patterns of two unknown recombinant strains were found to be CRFOI_AE/B （B＇） and CRF01_AE/C/B（B＇）, respectively. Conclusion CRF01_AE was the dominant HIV-1 subtype in Guangxi Autonomous Region from 2010 to 2012, with heterosexual transmission as its main spreading route. The two unknown recombinant strains in Guangxi Autonomous Region were reconstructed by subtype CRF01_AE and CRF_BC.