2009年浙江省HIV-1型CRF01_AE流行株分布特征

Molecular characteristics of HIV-1 CRF01_ AE strains in Zhejiang province in 2009

目的了解2009年浙江省HIV-1型CRF01_AE重组毒株在浙江省随访HIV感染者和艾滋病患者中的分布特征。方法以浙江省地市为单位进行分层，对2009年随访的H1V感染者和艾滋病患者随机抽样确定303例研究对象，收集调查对象信息并采集样本提取DNA，用PCR方法扩增gag部分基因片段，测定序列并进行分子流行病学分析。结果303例研究对象中扩增阳性并成功测序的共有225例。其中，CRF01_AE重组型占58．67％（132／225）。感染CRF01_AE毒株的调查对象中，性传播者占90．91％（120／132），其中异性性传播占65．91％（87／132），男男性行为传播者占25．00％（33／132）。系统树分析表明，感染CRF01_AE毒株的HIV感染者及艾滋病患者的病毒系统进化树存在3个分支簇，组内基因遗传距离分别为0．037±0．011、0．034±0．008、0．047±0．010（P〈0．05）。同性传播感染者序列高度集中在簇1（96．97％，32／33），且与异性传播感染者序列并存，且与江苏、河南郑州、辽宁和河北石家庄流行株有亲缘关系。结论CRF01_AE毒株在浙江省随访的HIV感染者及艾滋病患者中分布最广，以性传播为主（异性传播居多），同性传播毒株自成体系，但有向异性传播感染者扩散的现象。

Objective To analyze the molecular epidemiological characteristics of HIV-1 subtype CRF01_AE strains being prevailed among HIV/AIDS in Zhejiang province in 2009. Methods A total of 303 subjects were identified by stratified random sampling among HIV infected individuals in Zhejiang province in 2009. Gag fragments of the HIV-1 strains were amplified by nested polymerase chain reaction from the DNA extracted from whole blood of HIV-1 infected individuals. FCR products were sequenced and analyzed by phylogenetie method. Results A total of 132 HIV-1 subtype CRF01_AE sequences were identified from the 225 samples that sequenced successfully, accounting for 58, 67% （ 132/225 ）, A total of 90. 91% （ 120/132 ） CRF01_AE strains infected HIV/AIDS were transmitted mainly by sexual contacts. A total of 65.91% （87/ 132） of the cases infected by heterosexual route and 25.00% （33/132） by homosexual route. There were three main clusters in the phylogenetic tree. Pairwise DNA distance within three groups was 0. 037 _＋ 0. 011, 0. 034 ＋_ 0. 008 and 0. 047 ＋ 0. 010, which has statistical significance （ P 〈 0. 05 ） . Distribution of the sequence of homosexual behavior infected individuals was relatively concentrated in clusters one（96. 97%, 32/33 ） , and crossed with heterosexual behavior infectors, and presented the close relations with strains from Jiangsu province, Zhengzhou of Henan province, Liaoning province, Shijiazhuang of Hehei province. Conclusion The CRF01 _AE strains were the dominant subtypes among HIV infected individuals. The majority of the CRF01_AE infected cases had high risk sexual behavior. The heterosexual infected cases were more than homosexual cases. The circulating status of CRF01 _AE strains in homosexual population was relatively independent, but also had evidence of transmission from man who have sex with man to heterosexual population.