广西钦州市2016-2018年新报告HIV感染者不同基因型首次CD4^+T细胞计数分析

HIV genetic subtypes and comparison of first CD4^+T cell counts in newly reported HIV infections in Qinzhou,Guangxi,2016-2018

目的分析钦州市2016-2018年新报告HIV感染者的HIV基因型构成,比较感染者不同HIV亚型亚簇的首次CD4^+T淋巴细胞计数(CD4),为艾滋病防控工作提供数据支持。方法选取艾滋病综合防治信息系统中钦州市2016-2018年新发现HIV感染者,对感染者血浆进行病毒RNA提取、逆转录扩增、测序和亚型亚簇判定。采用Kruskal-Wails H秩和检验比较三种主要HIV亚型感染者的首次CD4,采用Wilcoxon秩和检验比较两种主要HIV亚簇感染者的首次CD4。结果本次研究共纳入1666例HIV感染者。CRF01_AE、CRF07_BC和CRF08_BC三种主要亚型的构成比分别是56.7%(945/1666)、9.3%(155/1666)和27.4%(457/1666),其首次CD4的中位数(四分位数间距)[M(P25,P75)]分别是146(37,308)、254(181,375)和218(112,348)个/μL。CRF01_AE(Cluster 1)和CRF01_AE(Cluster 2)亚簇的构成比分别是10.4%(174/1666)和42.0%(700/1666),其首次CD4的M(P25,P75)分别是185(43,344)、128(34,293)个/μL,CRF01_AE(Cluster 2)毒株同国内和越南的参考株成簇。CRF01_AE感染者的首次CD4低于CRF07_BC和CRF08_BC感染者(Z=-6.32,P<0.05;Z=-6.05,P<0.05);CRF01_AE(Cluster 2)感染者首次CD4低于CRF01_AE(Cluster 1)感染者(Z=-1.98,P<0.05)。结论2016-2018年钦州市新报告HIV感染者基因亚型中以CRF01_AE为主,其首次CD4低于其他亚型;该亚型中Cluster 2亚簇构成比最大,其首次CD4低于Cluster 1亚簇;以Cluster 2为代表的CRF01_AE基因型毒株在当地造成的艾滋病流行危害大。

Objective To analyze the genotype characteristics of newly reported HIV patients in Qinzhou City from 2016 to 2018,and compare the first reported CD4^+T lymphocyte counts(CD4)of different HIV subtypes,so as to provide data evidence for AIDS prevention and control.Methods The newly discovered HIV patients in Qinzhou City from 2016 to 2018 were selected for extracting viral RNA,reverse transcription amplification,sequencing and genotyping.Kruskal-Wallis H test was used to compare the first CD4 of major HIV subtypes,and Wilcoxon test was used to compare the first CD4 of two major HIV clusters.Results A total of 1666 HIV patients were included in this study.The proportions of CRF01_AE,CRF07_BC and CRF08_BC were 56.7%(945/1666),9.3%(155/1666),27.4%(457/1666),and the median interquartile range of the first CD4 were 146(37,308),254(181,375)and 218(112,348)cells/mL,respectively.The proportions of CRF01_AE(Cluster1)and CRF01_AE(Cluster 2)were 10.4%(174/1666)and 42.0%(700/1666),and the median interquartile range of the first CD4 were 185(43,344),128(34,293)cells/mL,respectively.CRF01_AE(Cluster 2)strains were clustered with reference strains from China and Vietnam.The first CD4 in patients with CRF01_AE was lower than that of the first CD4 in patients with CRF07_BC and CRF08_BC(Z=-6.32,P<0.05;Z=-6.05,P<0.05).The first CD4 in patients with CRF01_AE(cluster 2)was lower than that in the CRF01_AE(cluster 1)(Z=-1.98,P<0.05).Conclusion CRF01_AE and CRF01_AE(Cluster 2)are the dominant genotypes in newly reported HIV infected patients in Qinzhou City,and the patients'first CD4 is lower than CRF01_AE(Cluster 1).These genotype viruses of HIV cause great epidemic hazards in local areas.