上海市静安区2013年新报告感染者的HIV-1分子流行病学研究

Molecular epidemiologic study of human immunodeficiency virus type 1 in Jingan district of Shanghai in 2013

目的了解上海市静安区2013年新发现的、未经抗病毒治疗的艾滋病病毒1型（HIV-1）感染者的亚型分布特征,为该区制定艾滋病防治策略提供科学依据。方法选取2013年新发现的HIV-l感染者血浆标本144份,运用反转录-聚合酶链反应（RT-PCR）扩增,进行DNA测序及系统进化树分析,并结合流行病学资料进行分析。结果⑴获得104份pol区基因片段,其中亚型分布显示,CRF01_AE亚型所占比例最大,为73.1%（76/104）,其次为CRF07_BC为19.2%（20/104）;B亚型为4.8%（5/104）;CRF08_BC为1.9%（2/104）;并发现新的重组体CRF 59_01B亚型为1.0%（1/104）。⑵HIV-1基因亚型与年龄分布（χ^2=17.72,P〈0.05）、传播途径有统计学关联（χ^2=20.11,P〈0.05）,和CD4＋T淋巴细胞分组（χ^2=12.83,P〈0.05）之间有统计学差异。⑶Logistic回归分析显示,50岁以上及基因亚型是HIV进展为艾滋病的主要影响因素。结论男男同性性传播是静安区HIV-1感染的主要传播途径,HIV-1感染者中病毒基因亚型具有多样化,应加强对感染者的基因亚型监测。

Objective To study the human immunodeficiency vius-1（HIV-1）subtype distribution of HIV-1infected individuals diagnosed in 2013 and living in Jingan district of Shanghai,and to provide a basis for development of AIDS prevention and control strategy.Methods 144 plasma samples of HIV-1infection were selected,and pol gene fragments were amplified by nested RT-PCR,followed by DNA sequencing and phylogenetic subtyping,and combined with epidemiological analysis.Results 1）83pol gene fragments were obtained.Subtyping result showed73.1%（76/104）of subtype CRF01_AE,followed by 19.2%（20/104）of subtype CRF07_BC,4.8%（5/104）of subtype B,and 1.9%（2/104）of subtype CRF08_BC.A new recombinant subtype CRF 59_01Bwas discovered by1.0%（1/104）.2）HIV-1subtypes were statistically different in age distribution（χ^2=17.72,P〈0.05）,transmission（χ^2=20.11,P〈0.05）,and the group of CD4（χ^2=12.83,P〈0.05）respectively.3）Logistic-regression analyses demonstrated that the age over 50 years and subtype distribution were factors in progression of HIV to AIDS.Conclusion Heterosexual transmission is the major way of HIV-1infection in Jingan district.Surveillance of diverse HIV-1subtypes should be strengthened.