2018年新报告HIV-1感染者省际传播特征分析

Characteristics of inter-provincial transmission of newly reported HIV-1 infected people in 2018

目的分析省际1型艾滋病病毒(HIV-1)的传播特征,为实施精准防控进而减少HIV-1在我国的流行提供科学数据。方法对2018年当年新报告的HIV-1感染者进行抽样调查。收集血样并提取病毒核糖核酸,获得pol区部分片段的序列,构建系统进化树。运用HIV-TRACE构建分子网络并筛选出跨省分子簇。结果共调查31个省市,获得符合要求的序列4276条;在1.5%基因距离阈值下共鉴定出375个分子簇,入网序列52.4%(2241条);跨省分子簇39个,入网30.4%(1300条)。跨省分子簇66.5%(865/1300)为CRF07_BC,跨省传播更倾向于形成大簇传播。仅在省内分子簇出现的感染者占22.0%,处于跨省分子簇者是仅在省内分子簇者的1.38倍。跨省传播高于全国平均水平的省市有17个(P均<0.05);深圳、广东、陕西是我国HIV-1跨省传播排在前列的地区。结论CRF07_BC在跨省传播中占据重要地位;处于跨省传播簇中的感染者超过了单纯省内簇中的感染者,各省市间人员的流动对我国艾滋病疫情的传播扩散有促进作用。

Objective To study the characteristics of HIV-1 infection of inter-provincial transmission,so as provide scientific data for implementation of HIV prevention and control strategies in China.Methods A sample survey was conducted on newly reported HIV-1 infected people in 2018.Blood samples were collected and virus RNA was extracted to obtain the sequence of fragments in the pol region.Then phylogenetic tree was constructed.Molecular networks were constructed by using HIV-TRACE and inter-provincial molecular clusters were screened out.Results A total of 31 provinces and cities were surveyed,and 4276 sequences meeting the requirements were obtained.A total of 375 molecular clusters were identified under the 1.5%gene distance threshold,and 52.4%(2241/4276)were connected.There were 39 inter-provincial molecular clusters,with 30.4%(1300/4276)connected to the network.Inter-provincial molecular clusters were dominated by CRF07_BC(66.5%,865/1300),and inter-provincial transmission tended to form large cluster transmission.Only 22.0%of infections appeared in intra-provincial molecular clusters,and those in inter-provincial molecular clusters were 1.38 times those in intra-provincial molecular clusters only.There were 17 provinces and cities with inter-provincial transmission higher than the national average(all P<0.05).Shenzhen,Guangdong,and Shaanxi were among the top regions for the inter-provincial transmission of HIV-1 in China.Conclusion CRF07_BC has an important position in inter-provincial transmission.The number of infected people in the inter-provincial transmission cluster exceeds that in the simple intra-provincial cluster.The flow of people among provinces and cities has a positive effect on the prevalence of AIDS epidemic in China.