2014-2016年无锡市HIV/AIDS病毒亚型变异分析

Analysis of virus subtype variation among HIV/AIDS in Wuxi city,2014-2016

目的了解江苏省无锡市2014—2016年随访的HIV/AIDS人群病毒亚型的变化特征及其影响因素。方法以2014年无锡市HIV/AIDS人群为研究对象,开展HIV分子流行病学及随访研究。收集流行病学相关信息,从采集的血液样本中提取DNA,通过nest-PCR扩增pol基因片段并测序,ChromasPro1.6软件和MEGA 7.0软件构建HIV-1序列数据库,并采用FastTree2.1.10软件构建系统进化树进行亚型的确认;2016年随访相同人群,再次检测HIV亚型,分析两年间亚型变异情况,多因素Logistic回归探讨亚型变异的影响因素。结果共收集2014年与2016年同一HIV/AIDS患者612例,研究对象年龄主要集中在30岁及以上(85.46%,523/612),其中≥50岁人群比例较高(228/612,37.25%)。传播途径以同性性传播为主,占49.67%。共计检测1224例样本,检出CRF01_AE、CRF07_BC、B、CRF08_BC、CRF67_01B、CRF55_01B、CRF68_01B这7种HIV-1亚型和5种独特重组型(URFs)。CRF01_AE和CRF07_BC仍然是江苏省无锡市最主要的基因型,占66.75%。URFs重组毒株有29例,占3.56%。2014—2016年两年间感染者亚型变异率为14.63%,最常见的变异情况为CRF01_AE转变为CRF07_BC(13.95%)。婚姻状况(OR=0.363,95%CI:0.137~0.964)和基线CD4水平(OR=0.414,95%CI:0.192~0.891)与研究对象亚型变异相关。结论无锡市HIV/AIDS感染者中的HIV-1亚型多样且复杂,重组亚型占比不断上升,难以确定基因型的URFs显著增加,感染者亚型变异率较高,应继续加强对亚型的监测。

Objective To investigate the variation characteristics and influencing factors of HIV/AIDS subtypes in Wuxi city of Jiangsu Province from 2014 to 2016.Methods HIV/AIDS population in Wuxi city in 2014 was selected as the research object,and the HIV molecular epidemiology and follow-up study were carried out.Collect epidemiological information,extract DNA from blood samples,amplify pol gene fragment by nest-PCR and sequence,use ChromasPro 1.6 software and MEGA 7.0 software to construct the HIV-1 sequence database,and use FastTree2.1.10 software to construct the phylogenetic tree to confirm the subtype;in 2016,the same population was followed up,and the HIV subtype variation was analyzed,and the influencing factors of subtype variation were explored by multivariate logistic regression.Results A total of 612 HIV/AIDS cases in 2014 and 2016 were collected.The age of the subjects was mainly 30 years old or above(85.46%,523/612),and the proportion of people over 50 years old was higher(228/612,37.25%).The main route of transmission was homosexuality,accounting for 49.67%.A total of 1224 samples were detected and CRF01_AE、CRF07_BC、B、CRF08_BC、CRF67_01B、CRF55_01B、CRF68_01B,7 subtypes of HIV-1 and 5 unique recombinant types(URFs)was detected.CRF01_AE and CRF07_BC was still the main genotype in Wuxi,Jiangsu Province,accounting for 66.75%.There were 29 cases(3.56%)of URFs recombinant strains.During 2014-2016,the variation rate of subtypes was 14.63%,and the most common variation was CRF01_AE changes to CRF07_BC(13.95%).Marital status(OR=0.363,95%CI:0.137-0.964)and baseline CD4 level(OR=0.414,95%CI:0.192-0.891)were associated with subtype variation.Conclusions The HIV-1 subtypes of HIV/AIDS patients in Wuxi city are diverse and complex,the proportion of recombinant subtypes is rising,the URFs that are difficult to determine the genotype increase significantly,and the variation rate of HIV-1 subtypes among HIV/AIDS infected people is high.It is necessary to strengthen the monitoring of HIV-1 subtypes.