2014-2018年浙江省江山市中老年HIV/AIDS的HIV-1亚型和分子簇特征研究

HIV-1 subtypes and molecular cluster characteristics of middle-aged and elderly HIV/AIDS patients in Jiangshan,Zhejiang,2014–2018

目的了解浙江省江山市中老年人类免疫缺陷病毒感染者和艾滋病患者(HIV/AIDS)的HIV亚型分布情况和分子传播簇特征,为该市HIV流行趋势分析和疫情防控提供技术支持。方法对江山市2014—2018年新诊断的中老年HIV/AIDS开展分子流行病学研究,从94例感染者(含3例暗娼)血浆中提取RNA,通过反转录–聚合酶链式反应和巢式PCR扩增pol区基因并进行核酸测序,运用MEGA 6.0软件构建Neighbor-Joining系统进化树分析亚型,利用Cytoscape 3.6.0软件对遗传距离≤0.01的序列构建HIV分子簇。结果 HIV毒株序列成功获得率为86.2%(81/94),毒株亚型以CRF01AE为主(93.8%,76/81),其余分别为CRF07BC型3例(3.7%)和B亚型2例(2.5%);共发现3个分子传播簇,均由CRF01AE亚型构成,总成簇比例为84.0%(68/81),大簇包含64例病例(含1例阳性暗娼),2个小簇均由2例病例组成。结论江山市中老年HIV/AIDS亚型以CRF01AE为主且种类较为单一,存在与阳性暗娼紧密关联的传播簇,应加强对簇内病例的流行病学调查,以便实施有针对性的公共卫生干预。

Objective To understand the distribution of HIV subtypes and the characteristics of molecular transmission clusters of middle-aged and elderly HIV/AIDS patients in Jiangshan of Zhejiang province, and provide technical support for the analysis of HIV epidemic trends and the prevention and control of the epidemic. Methods Newly HIV-1 diagnosed middle aged and elderly HIV/AIDS patients in Jiangshan from 2014 to 2018 were enrolled in this molecular epidemiological study. Total viral RNA was extracted from plasma of 94 patients, including 3 female sex workers(FSWs). The pol genes were amplified with RT-PCR and nested PCR, and then the nucleic acid was sequenced. Software MEGA 6.0 was applied to construct Neighbor-Joining phylogenetic tree for subtype analysis. Software Cytoscape 3.6.0 was applied to construct HIV molecular clusters for sequences with a genetic distance ≤0.01. Results The success rate of sequence acquisition was 86.2%(81/94). The predominant subtype was CRF01_AE(93.8%, 76/81), followed by CRF07_BC in 3 cases(3.7%) and subtype B in2 cases(2.5%). Three molecular transmission clusters consisting of subtype CRF01_AE were found. The total clustered rate was 84.0%(68/81). The large cluster contained 64 cases(including 1 positive FSW), and two small clusters were all composed of 2 cases. Conclusion The HIV subtype of middle-aged and elderly people in Jiangshan was mainly CRF01_AE.Transmission clusters that closely related to positive FSWs were found. Therefore, the case epidemiological investigation in the clusters should be strengthened in order to implement targeted public health intervention.