福建省艾滋病感染的流行病学和病毒亚型之间相互关系的研究

Relationship between epidemiology of HIV-1 infection and HIV-1 subtypes in Fujian province

目的 通过分子流行病学调查 ,明确福建省人类免疫缺陷病毒 1(HIV 1)流行毒株亚型与艾滋病 (AIDS)流行的关系。方法 通过艾滋病监测网络发现全省HIV/AIDS病例 ,应用核苷酸序列分析技术确定HIV 1亚型 ,结合流行病学资料分析福建省AIDS的流行状况。结果 截至 2 0 0 0年底 ,全省累计发现 188例HIV感染者 ,其中AIDS 5 9例 (已死亡 5 3例 )。经异性性接触感染占6 5 .4% ,经血途径感染占 9.0 % ,境外感染占 44 .1% ,其中在东南亚等国家感染约占 83.1% ,境内感染占 39.9%。 41例HIV/AIDS病例的HIV 1亚型分析表明福建省存在A、B、C和E 4种亚型 ,E亚型占75 .6 % (31/4 1) ,均为经异性性接触途径感染 ;B亚型 17.1% (7/4 1) ,主要经血途径感染。A和C亚型分别为 1和 2例。E亚型基因离散率为 (12 .2 45± 3.894) % ,B亚型基因离散率为 (10 .76 2±2 .70 7) %。表明福建省E亚型流行株的来源复杂 ,与感染地点、时间有关。结论 福建省AIDS流行速度正在加快 ,病毒感染者主要经异性性接触途径感染 ,HIV

Objective To explore the relationship of AIDS epidemic and HIV 1 subtype in Fujian province of China based on molecular findings. Methods HIV 1 infected persons and patient with AIDS(HIV/AIDS) were identified by AIDS surveillance project in the province. AIDS epidemic situation was estimated by related data collected from the HIV/AIDS cases. HIV 1 C2 V3 region amplified from the PBMC DNA of HIV/AIDS cases was analysed by nucleotide sequencing to identified HIV 1 subtype. Results One hundred and eighty eight cases of HIV/AIDS were found from 1987 to the end of 2000. Among 59 AIDS cases, 53 had died. HIV infection through heterosexual contacts took up 65.4 %, including 44.1 % of them infected abroad. Out of them, 83.1 % were infected in Southeast Asia. Thirty nine point nine percentage of the total HIV(+) were infected in China, while 9.0 % were infected through blood transmission. Sequence analysis from 41 specimens showed that there were 4 kinds of HIV 1 subtypes, including A,B,C and E. Subtype E took up 75.6 %(31/41),all infected by heterosexual contacts; subtype B taking up 17.1 %(7/41) with most of them infected through blood transmission; subtype A and C were seen only 1 and 2 cases respectively. Gene divergence of innergroup of subtypes E was 12.245 %± 3.894 %, while subtype B was 10.762 %± 2.707 %. The high divergence of subtype E could be attributed to the region and time of infection. Conclusion HIV prevalent rate has been increasing in Fujian with major transmission route of heterosexual contact. The dominant strain of HIV 1 was subtype E.