云南省64例HIV-1独特重组毒株重组特征及流行病学分析

Recombination characteristics and epidemiological analysis of 64 HIV-1 unique recombinant forms in Yunnan Province

目的 调查云南省64株HIV-1独特型重组毒株的重组特征及流行病学特征。方法 选择2017年云南省传染病医院样本库HIV-1感染者和艾滋病患者血浆样本,采样集时患者抗病毒治疗时间持续大于半年,同时收集其人口学信息,运用RT-PCR方法扩增gag-pol区半分子基因序列,使用RIP和jpHMM软件进行重组分析,采用MEGA6.06软件共同构建Neighbor-joining系统进化树对该毒株的同源性关系进行分析。结果 64例独特型重组毒株主要以男性为主,感染途径以异性性传播和静脉药瘾为主,样本来源于云南省11个州市,主要来自于昆明、红河、德宏、临沧、大理和保山。64例独特型重组毒株主要有4类重组模式,分别是B/C重组、01_AE/B/C重组、01_AE/B重组和01_AE/C重组,分别占到70.31%、18.75%、7.81%和3.13%,其中4种不同类型的重组模式在不同年龄段的差异有统计学意义,64株毒株在系统进化树上分别形成不同的进化簇。结论 云南省近年来重组毒株占比逐年增加,其重组的类型和模式比较复杂,对疾病的防控带来较大的困难,这提示应密切监测重组毒株流行趋势变化,同时加强对这一特殊人群的管理,以减少独特型重组毒株的传播。

Objective To investigate the recombination and epidemiological characteristics of 64 HIV-1 unique recombinant strains in Yunnan Province.Methods Selected plasma samples of HIV-1 infected/AIDS patients from Yunnan Infectious Diseases Hospital’s sample bank in 2017.At the time of sampling,the antiviral treatment time of patients lasted more than half a year,and their demographic information was collected at the same time.The semi molecular gene sequence of gag-pol region was amplified by RT-PCR.RIP and jpHMM software were used to analyze the reorganization.And MEGA6.06 was used to construct the neighbor joining phylogenetic tree to analyze the homology relationship of the strains.Results A total of 64 unique recombinant strains were mainly male,and the infection routes were mainly heterosexual transmission and intravenous drug addiction.The samples were from 11 cities in Yunnan Province,mainly from Kunming,Honghe,Dehong,Lincang,Dali and Baoshan.There were mainly 4 types of recombination modes in the 64 unique recombinant strains,namely B/C recombination,01_AE/B/C recombination,01_AE/B recombination,and 01_AE/C recombination,accounted for 70.31%,18.75%,7.81%,and 3.13% respectively.There were statistically significant differences in the distribution of 4 types of recombination patterns in age,and 64 strains formed different evolution clusters on the phylogenetic tree respectively.Conclusion The proportion of recombinant strains in Yunnan has increased year by year in recent years.The types and patterns of recombination are more complicated,which brings great difficulties to the prevention and control of the disease.This suggests that we should closely monitor the epidemic trend of recombinant strains and and the management of this special population should be strengthened to reduce the transmission of unique recombinant strains.