浙江省2003-2005年HIV-1感染者分子流行病学研究

Moleculo-epidemiological study of HIV infection cases in 2003-2005 in Zhejiang province

目的掌握浙江省2003-2005年新发现感染者艾滋病病毒Ⅰ型(HIV-1)毒株基因亚型分布和变异情况。方法对2003-2005年浙江省境内检测新发现的HIV-1感染者进行一般流行病学调查并采集血样,提取前病毒DNA,使用套式聚合酶链反应对gag基因区进行扩增并测定其序列。结果采集143份血样,112份扩增阳性,检出CRF01-AE亚型43例,CRF07-BC 37例,CRF08-BC 11例,B亚型20例,CRF02-AG 1例。CRF01-AE分布在11个市中的9个市,主要存在于异性性途径感染者中(53.5%),并已成为外省籍注射吸毒感染者的主要构成(44.8%)。CRF01-AE和CRF07-BC的亚型组内平均离散率在静脉吸毒感染者和性传播感染者中比较,差异有统计学意义。结论浙江省2003-2005年新检出感染者HIV-1毒株呈现多重组型别特征,CRF01-AE成为分布最广的类别,呈现扩大流行的趋势。HIV-1在性乱人群之间的传播要比在注射吸毒人群复杂,变异更大。

Objective To study the distribution and variation of HIV-1 subtypes among newly detected HIV-1 infection cases in 2003 - 2005 in Zhejiang province and to analyze its epidemiological feature and trend. Methods Epidemiological investigation was carried out and blood samples were collected in newly detected cases of HIV-linfection in 2003 - 2005 in Zhejiang province.Extracted proviral DNA and gag region of HIV-1 was amplified with nested polymerized chain reaction（nested PCR）and sequenced.Results A total of 112 sequences were amplified from 143 collected blood samples. Of the tested samples there were：5 HIV-1 subtypes or circulating recombinant forms（CRFs）, 43 cases of CRF01- AE,37 cases of CRF07-BC,11 cases of CRF08-BC,20 cases of B subtype,and I case of CRF02-AG.CRF01-AE was detected in 9 of 11 surveyed cities,mainly in subjects infected via heterosexual contacts（53.5 % ）and also in immigrant subjects infected via drug injection（44.8 % ）.The difference in inter group genetic distance of CRF01-AE and CRF07-BC between IDUs and subjects infected via sex had statistic significance.Conclusions The newly detected HIV-1 strains in 2003 -2005 in Zhejiang province are characterized with CRFs. CRE01-AE subtype of HIV-1 is the most widely distributed virus strain and tends to spread in the province. The HIV transmission is more complicated and with greater variation in subjects infected via sex than in subjects infected via drug injection.