261名南京地区男男性行为者HIV感染及免疫情况与分子流行特征研究

Study on HIV infection,immunization and molecular epidemic characteristics among 261 men who have sex with men in Nanjing

目的了解南京市男男性行为人群(MSM)人类免疫缺陷病毒(HIV)感染情况,分析HIV感染者的感染特征、免疫状况以及分子亚型,为MSM人群的HIV防治提供依据。方法收集2016年10-12月期间招募的MSM问卷信息,检测样本HIV抗体,追踪HIV阳性感染者并再次采集血样检测T淋巴细胞亚群和分子亚型。结果本次研究涉及MSM共261名,78.93%年龄<35岁,文化程度多集中在大专及以上(66.28%)。HIV感染率为9.96%;大专及以上学历HIV感染率(6.94%)较低,合并梅毒感染者HIV感染率(30.95%)则更高,差异均有统计学意义(P<0.001)。MSM人群HIV感染者CD4+T淋巴细胞计数平均值为(362.20±216.53)个/μL。该人群的HIV感染流行亚型主要为CRF01-AE(42.86%)和CRF07-BC(35.71%)。结论南京市MSM人群的HIV感染率较高,且低文化程度和感染梅毒(TP)是HIV感染的危险因素,可有针对性的开展干预。人群中HIV感染者的免疫状况处于较低水平,优势毒株依旧为CRF01-AE和CRF07-BC,今后需加强分子流行病学监测。

Objective To understand the infection situation of human immunodeficiency virus(HIV) in men who have sex with men(MSM) in Nanjing,and analyze the infection characteristics,immune status and molecular subtypes of HIV infected people.Methods Information of MSM questionnaire was collected from October to December 2016;HIV antibody was detected;HIV positive patients were tracked and blood samples were collected to detect T lymphocyte subsets and molecular subtypes.Results 261 MSM were involved in this study;78.93% of them were younger than 35 years old,and most of them were educated in college and above(66.28%).The rate of HIV infection was 9.96%;the rate of HIV infection was relatively low(6.94%) for college education and above,and higher(30.95%) for syphilis infection(P<0.001).The average CD4^+T lymphocyte count of HIV infected MSM was(362.20±216.53)/μL.The main subtypes of HIV infection were CRF01-AE(42.86%) and CRF07-BC(35.71%).Conclusions The HIV infection rate of MSM in Nanjing was high,and low education and TP infection were the risk factors of HIV infection,which could be targeted intervention.The immune status of HIV infected people was at a low level,and the dominant strains were CRF01-AE and CRF07-BC..The epidemiological status should be monitored in the future.