天津市男男性行为人群HIV感染者毒株亚型和成簇特点

Analysis on the Characteristics of HIV genetic diversity and clusters among MSMs in Tianjin

目的了解我市男男性行为人群(men who have sex with men,MSM)人免疫缺陷病毒(human immunodeficiency virus,HIV)感染者毒株的亚型分布和成簇特点。方法收集2013-2017年MSM随访研究中新发现和队列中阳转的未经抗逆转录病毒治疗(antiretroviral therapy,ART)的HIV感染者血浆样本,经RNA提取和扩增,共获得100份pol区序列,进行基因型、耐药突变和分子进化分析,并与人口学和行为学资料相结合分析其成簇特点。结果HIV感染者流行的亚型依次为CRF01_AE占60.0%(60/100),CRF07_BC占28.0%(28/100),B亚型占6.0%(6/100),CRF55_01B亚型占4.0%(4/100),其他独特型二代重组亚型占2.0%(2/100)。传播性耐药(trans-mitteddrugresistance,TDR)流行率为7%(7/100),其中不同亚型的流行率依次为B亚型3.0%(3/100)、CRF01_AE2.0%(2/100)、CRF07_BC1.0%(1/100)和CRF55_01B1.0%(1/100)。耐药突变以NNRTIs突变为主,占4.0%(4/100),其次为NRTIs突变占2.0%(2/100),PIs突变占1%(1/100)。成簇样本占31.0%(31/100),共分布在13个传播簇内,成簇和非成簇的感染者的亚型、户籍和性病史差异均有统计学意义(均有P<0.05)。结论天津市MSM感染者中HIV毒株亚型分布情况日趋复杂,新型重组和耐药毒株不断出现并传播,应引起高度重视。

Objective To understand the genetic diversity and characteristics of clusters of HIV strains among MSMs in Tianjin. Methods Pol gene fragments were obtained from 100 newly discovered and transformed HIV-positive HIV-infected antiretro viral therapy (ART)-nave MSM who visited a retrospective cohort study of MSMs from June 2013 to June 2017 in Tianjin,by viral plasma RNA extraction and amplification. Genetic,drug-resistance and phylogenetic analyses were used to evaluate the characteristics of HIV molecular clusters combined with patient demographic and behavioral characteristics within the context of the entire cohort. Results 60. 0% (60/100),28. 0% (28/100),6. 0% (6/100), 4. 0% (4100) and 2. 0% (2/100) of the individuals were infected under HIV subtypes CRF01_AE,CRF07_BC,B, CRF55_01B and URFs. 7. 0% (7/100) of infectors had transmitted drug-resistance mutations. The TDR prevalence rates of different subtypes were 3. 0% (3/100) of subtype B,2. 0% (2/100) of CRF01_AE,1. 0% (1/100) of CRF07_BC and 1. 0% (1/100) of CRF55_01B. TDRs was predominantly towards NNRTIs 4. 0% (4/100). In contrast,TDR to NRTIs and PIs were 2. 0% (2/100) and 1. 0% (1/100) respectively. We identified 13 transmission clusters including 31 infectors. There were statistically significant differences in subtype,registration and history of sexually transmitted diseases between clustered and non-clustered infected people (P <0. 050). Conclusions Results from this study suggested that the prevalence trends of HIV-1 CRFs,URFs and TDR strains among MSM were not optimistic. More attentions should be paid for prevention and control of HIV epidemic in Tianjin.