淮安市艾滋病异性性传播方式及分子流行病学研究

Study of spreading mode and molecular epidemiological characteristics of heterosexual transmitted HIV in Huai'an

目的了解淮安市经异性性传播感染的HIV/AIDS人群的性传播构成方式以及病毒亚型分布情况。方法对艾滋病病例报告系统中,现住址为淮安市的经异性性传播病例进行面对面问卷调查,内容包括社会人口学特征和高危行为史。从经异性性传播感染的HIV/AIDS病例血液中提取DNA或RNA,用巢式PCR或RT-PCR方法扩增gag、env基因区片段,测定序列并分析。结果共调查HIV/AIDS病例166例,经商业异性性传播者占38.0%,经婚内或者固定性伴侣性传播者占40.4%,经非婚非商业异性性传播者占21.7%。结合gag和env 2个基因片段,最终确定了103分样本的基因亚型,发现有6种HIV-1亚型和重组型,其中,CRF01_AE占52.4%、CRF07_BC占20.4%、CRF08_BC占11.7%、B'(泰国B)占9.7%、B(欧美B)占3.9%、CRF55_01B占1.9%。结论淮安市HIV经异性性传播方式以经婚内或固定性伴传播为主;感染HIV-1流行株较为复杂,存在6种亚型和重组型,其中CRF01_AE重组型是主要流行株。

Objective To understand the spreading mode constitution and virus subtype distribution of HIV/AIDS patients infected via heterosexual transmission route in Huaian. Methods Epidemiological survey was conducted by face-to-face interviews on HIV patients infected by heterosexual transmission who lived in Huai＇an using questionnaires. Socio-demographic characteristics, high-risk behavior exposure history were investigated. Blood DNA/RNA was extracted from heterosexual transmitted HIV patients, env and gag gene fragments were amplified by nest PCR or RT-PCR , followed by sequencing analysis. Results A total of 166 HIV/AIDS patients were surveyed, among which 38.0% Were infected by commercial heterosexual behaviors, 40.4% were infected by spouses and regular sexual partners, 21.7% were infected by non-commercial casual partners. Based on phylogentic anlysis of gag and env gene, a total of 103 samples were genotyped, 6 subtypes and recomhinants of HIV-1 were indentified, including CRF01_AE, CRF07_ BC ,CRF08_BC, B＇（Thailand） ,B（Europe/America） and CRF55_01B, accounting for 52.4%, 20.4%, 11.7%, 9.7%, 3.9% and 1.9% ,respectively. Conclusions The major spreading mode of HIV in Huai＇an via heterosexual transmission route was infection through spouse or regular sexual partners. The distribution of epidemic HIV-1 strains was complicated ,including 6 subtypes and recombinants, of which CRF01_AE was the predominant strain.