深圳市人类免疫缺陷病毒-1不同亚型分布与传播途径的关联性分析

The relationship between distribution of different subtypes of human immunodeficiency virus-1 and thetransmission routes in Shenzhen

目的了解深圳市HIV-1毒株的分布以及与传播途径的关联性。方法对429例HIV-1感染者进行流行病学调查，采集外周静脉抗凝血，提取核酸，反转录套式PCR扩增包膜蛋白（env）和核心蛋白（gag）基因，结合HIV数据库和Mega软件分析测序结果，确定亚型，建立进化树，计算各亚型不同传播途径基因离散率。结果在400份合格标本中，属于CRF01-AE207份，CRF07-BC115份，CRF08—13（214份，CRF02-AG1份，B亚型49份，C亚型14份。CRF01-AE涉及到同性、异性、静脉吸毒、医源性和血源性等传播途径，其中以性传播为主；血源性传播的10份标本中，9份为B亚型，且B亚型在各传播途径的基因离散率均高于其他亚型。在进化树上，各种传播途径在同-亚型内形成相对独立的簇，但也有交叉。结论深圳市HIV-1亚型以重组型为主；传播途径以性传播为主；各亚型在各传播途径分布不均衡，各有特点；各传播途径之间存在关联性。

[Abstract] Objective To investigate the distribution of human immunodeficiency virus-1 （HIV- 1） subtypes and the relationship with transmission routes in Shenzhen city. Methods The epidemiological survey was conducted in 429 subjects with HIV-1 infection. Vein blood was collected and prepared with anticoagulation. Thereafter, the viral nucleic acid was extracted and subsequently amplified for HIV1 env, gag genes by reverse transcription nested polymerase chain reaction. The viral sequences were analyzed using Mega software and compared with those in HIV database. The HIV-1 subtypes were confirmed and evolutionary tree was established. The gene discrete rate of different subtypes was calculated. Results Four hundred qualified samples were identified as CRF01_ AE （n=207）, CRF07_BC （n=l15）, CRF08 _BC （n=14）, CRF02_AG （n=l）, B （n=49） and C （n= 14）, respectively. CRF01 AE was the predominant subtype that was detected in the subjects with different transmission routes, such as homosexual contact, heterosexual contact, intravenous drug use and hospital-acquired infection. Among these, sexual contact was the most common route. There were nine cases infected with subtype B HIV-1 in 10 case who were blood-borne. The gene discrete rate was more significant in subtype B HIV 1 compared to the other subtypes. According to the evolutionary tree analysis, the viruses under the same subtype formed the relatively independent clusters by different transmission routes. But some overlaps were observed as well. ConclusionsThere are many HIV-1 subtypes in HIV-1 infected subjects in Shenzhen, while the recombinant viruses present as the predominant form. Transmission routes are various with sexual contact as the most common route. Every subset distributes unevenly and forms its own characteristic. Overlap can be observed among the gene distribution of different HIV-1 subtypes.