2013年上海市新发现HIV-1感染者中注射吸毒人群的基因亚型分析

HIV-1 subtype analysis in new HIV-1 infected injection drug users in Shanghai, 2013

目的:分析2013年上海市新发现的、未经抗病毒治疗的、注射吸毒的人类免疫缺陷病毒-1型(human immunodeficiency virus-1,HIV-1)感染者的基因亚型流行特点,为更好地针对该类人群制定科学有效的艾滋病防治干预措施提供依据。方法:应用反转录-聚合酶链反应(reverse transcription-polymerase chain reaction,RT-PCR)扩增、DNA测序、系统进化树,确定78例2013年本市新发现的注射吸毒HIV-1感染者的病毒亚型,并结合流行病学资料进行分析。结果:在78例标本中,成功获取66例患者的pol基因,扩增率达84.6%。经扩增、测序、判定基因亚型,结果显示,CRF07_BC重组亚型者为47例(71.2%);CRF01_AE重组亚型者为12例(18.2%),CRF08_BC重组亚型、B亚型、C亚型者分别为3例(4.5%)、2例(3.0%)和2例(3.0%)。感染途径不同,CRF07_BC和CRF01_AE重组亚型分布的差异有统计学意义(P=0.02);本市户籍与非本市户籍人口间5种基因亚型分布的差异有统计学意义(P<0.01)。结论:2013年上海市新发现的HIV-1感染者中,注射吸毒人群病毒基因亚型呈现多样性,其中以CRF07_BC占优势,应密切关注该人群,定期对其进行HIV-1亚型监测。

Objective： To investigate and analyze the epidemiological feature of human immunodeficiency virus-1（HIV-1） subtypes infections among injection drug users, newly found and untreated in 2013, Shanghai, for stipulating scientifically and effectively the strategy for intervention. Methods： Seventy-eight cases of new HIV-1 infected injection drug users were sampled and their plasma was collected. HIV-1 pol gene was amplified by reverse transcription polymerase chain reaction（RTPCR） and then the DNA was sequenced and analyzed by phylogenetic tree, and comprehensive analysis was performed in combination with epidemiological data. Results： Sixty-six samples（84.6%） have been successfully amplified, with the gene subtype including 47 cases of CRF07_BC（71.2%）, 12 cases of CRF01_AE（18.2%）, 3 cases of CRF08_BC（4.5%）, 2 cases of subtype B（3.0%） and 2 cases of subtype C（3.0%）. The difference in distribution of CRF07_BC and CRF01_AE showed statistical significant difference by infection source（P=0.02）; the 5 kinds of gene subtypes differed between residents and migrates（P〈0.01）. Conclusions： Genetic diversity of HIV-1 subtype infected injection drug users in Shanghai is complex, and the dominant gene subtype is CRF07_BC. More attention should be paid to this population and regular HIV-1 subtype survilliance is needed.