山西某县农村外来嫁入女性及配偶中HIV感染者病毒序列特征分析

Genetic features of HIV-1 strains circulating in immigrant women and their spouses in a rural district of Shanxi province

目的分析山西省某县农村外来嫁入女性及配偶中感染艾滋病病毒(HIV)的毒株分布和传染源,为制定有效的艾滋病防治措施提供科学依据。方法采集17名感染HIV的农村外来妇女及这些外来妇女的4例阳性配偶的外周血,提取前病毒DNA,应用套式PCR进行艾滋病病毒gag基因检测,使用GCG软件包对扩增序列进行分析,并对这些HIV感染者进行相关流行病学调查。结果在送检的21份HIV确认阳性的样本中,共获得18份gag基因序列。基于gag基因区的序列分析结果表明:其中13份为CRF01 AE亚型(占72.2%),1份为B’亚型(占5.6%),2份为B’/C重组型(占11.1%),1份为C亚型(占5.6%),另有1例样本不确定。B’/C重组与新报告的云南瑞丽发现的B/C重组亚型相似性最大。18份样本中有3对为HIV双阳性的夫妻,系统树分析表明,每对夫妻感染毒株在系统树上聚在一起,处于一个分支,彼此间的基因距离均很小(0.007～0.009),推测为近期的家庭内传染。结论山西以往的HIV感染者的主要来源为采供血途径,近年外来高危人口的大量输入,已是山西HIV感染人群的重要毒株来源,使该地区的流行毒株从单一型向多样化发展,并已有家庭内传播的发生。这种形式使该省艾滋病的防控工作更加复杂,今后外来高危人口应纳入当地省艾滋病疫情的重点监测对象,降低传播情况的发生。

Objective To determine the genotypes of HIV-1 strains circulating among married immigrant women and their spouses in a rural district of Shanxi province and to provide scientific evidences for HIV/AIDS control and prevention.Methods Blood samples were collected ：from 17 HIV-infected immigrant women and 4 infected spouses in a rural district of Shanxi province. Provirus DNA was extracted, HIV-1 gag genes were amplified by nested-PCR and sequenced directly with pairs of specifically designed primers, sequences were then analyzed by GCG software system to determine genotypes, and phylogenetic trees were established.Epidemic information of the HIV-infected women was also collected.Results HIV-1 gag genes were successfully amplified from 18 out of 21 HIV-1 positive samples and analyses were thereafter conducted. Of these 18 samples 13 were identified as HIV-1 CRF01-AE（72.2 % ）, and B＇ subtypes, BC recombinants and C subtype were identified in 1 （5.6 % ）, 2 （ 11.1% ） and 1 samples （5.6 % ）, respectively. The BC recombination identified in this group of population was different from CRF07-BC and CRF08-BC,but similar to what was recently reported in Ruili city of Yunnan province. Interestingly, HIV-1 sequences from each of these 3 paired couples were phylogenetically clustered in the identical branch of the phylogenetic tree, and the genetic distance between the couples was marginal, which supported the assumption thai： transmission of HIV-1 occurred recently within these couples.Conclusions The HIV-infected paid blood donors is the major HIV-infected population group in Shanxi province. Immigrant HIV-in- fected individuals have recently become the major source of HIV infection, and the expanded HIV-1 strain is moving from asingle B＇ strain to multiple subtypes, which poses a challenge for prevention and control of HIV/AIDS in Shanxi province. Therefore, surveillance of immigrant high risk population should be listed as a priority in controlling HIV infection in this province, and HIV counseling and testing, health education and behavioral interventions are urgently needed to prevent transmission of HIV-1 within families.