凉山州HIV/HCV共感染人群中HCV分子流行病学研究

Molecular Epidemiology of HCV in HIV/HCV Co-infection Patients in Liangshan Prefecture

目的分析凉山州HIV/HCV共感染人群中的亚型特点和流行规律,为预防提供科学依据。方法 2011-2012年从四川省凉山州某县彝族地区25岁以下HIV-1感染人群中采集抗凝血浆标本127份。提取病毒核酸,并扩增HIV pol区,进行序列测定和分析,确定HIV基因型。同时用ELISA法进行抗HCV的检测,经初筛和复检的抗HCV阳性的血浆,进一步用巢式PCR(nested-PCR)分别扩增HCV 5'NCR-core、E1-E2和NS5B 3个基因片段,并进行序列测定和分析,确定HCV基因亚型。结果凉山州HIV-1的人群中合并感染HCV感染率为53.5%。该地区HIV-1以CRF07-BC为主(95%),另外发现3例B亚型的毒株(5%)。而合并感染的HCV亚型较为复杂,包括1a(2例,4%);1b(3例,6%);3a(8例,17%);3b(14例,29%);6a(1例,2%);6U(19例,40%),6n(1例,2%)。结论凉山州某县彝族地区25岁以下人群中存在较高的HIV-1/HCV共感染率,且HCV亚型分布主要以3b和6U型为主,这与中国大陆以1b、2a型为主的流行特征有较大区别,提示该地区HCV的流行与云南地区吸毒人群的传播相关。

Objective To investigate the molecular epidemic and subtypes of hepatitis C virus （HCV） co - in- fection in the human immunodeficiency virus （HIV） patients in Liangshan prefecture. Methods A total of 127 whole blood samples were collected from HIV infected patients under 25 years old in Liangshan. HIV RNA was extracted and pol region was amplified for further sequence analysis and subtype determination. Test of antibod- ies against HCV （anti -HCV） was conducted and HCV RNA was detected by PCR amplification. Genotypes of HCV were determined by genetic characterization of HCV 5＇NCR - core, E1 - E2 and NSSB sequence. Re- suits Seroprevalence rate of HCV in HIV -infected people was 53.5% （68/127） and predominated by HIV CRF07 - BC. HCV subtype was more complex, including la （2 cases, 4% ） ; lb （3 cases, 7% ） ; 3a （8 cases, 18%）; 3b （14 cases, 31%）; 6a （1 case, 2%）; 6U （19 cases, 36%） and 6n （one cases, 2% ）. Conclusion The HIV/HCV co - infection rate was comparatively high in the population under 25 years old in Liangshan. The distribution of HCV genotypes or subtypes （3b and 6U） in this region is distinguished from China mainland where dominated by types of lb and 2a. The result implies that the HCV propagation inthis region is probably related to the prevalence of drug users in Yunnan.