淮安市新报告HIV-1感染者的分子传播网络特征研究

Characteristic genetic transmission networks among newly reported HIV-1 infected cases in Huai,an

目的 了解淮安市新报告人感染HIV-1毒株的流行特征、亚型及分子传播网络特征。方法 采集淮安籍HIV-1确证阳性感染者血液标本,利用巢式(RT-)PCR方法扩增pol基因片段,测序并构建分子传播网络。结果 淮安市新报告人感染的HIV-1基因亚型有9种,分别为CRF01_AE (38.5%,47/122)、CRF07_BC (38.5%,47/122)、CRF67_01B (8.2%,10/122)、CRF68_01B (4.9%,6/122)、B (3.3%,4/122)、CRF08_BC (3.3%,4/122)、CRF55_01B (1.6%,2/122)、CRF85_BC (0.8%,1/122)和CRF52_01B (0.8%,1/122)。60条pol基因序列形成10个分子传播簇,入网率为49.2%,其中最大的分子传播网络由CRF07_BC基因型构成。logistic回归分析显示已婚有配偶(与丧偶相比,OR=0.242,95%CI:0.006-0.972)、同性传播(与异性传播相比,OR=2.113,95%CI:1.020-4.377)、基因型CRF07_BC (与其他重组型相比,OR=5.972,95%CI:1.655-21.554)更容易进入HIV-1分子传播网络并传播流行。结论 淮安市新报告人感染HIV-1的基因型具有多样性,分子传播网络中存在耐药株传播风险,因此应加强HIV-1的分子流行病学调查,全面开展基线耐药监测,防止耐药毒株在人群中的进一步传播和扩散。

Objective To gain more insights into epidemiologic characteristics,genotype and molecular transmissionnetwork characteristics of newly reported HIV-1 infected cases in Huai'an.Methods The samples of local confirmed cases in Huai'an were collected with epidemiological information.HIV-1 pol genes were amplified by nested(RT-)PCR from(RNA)DNA,followed by sequencing,aligning and molecular transmission-network construction.Results The study revealed the distributions of HIV-1 genotypes among newly reported HIV-1 infected cases in Huai'an were as folloWS:CRF01_AE(38.5%,47/122)、CRF07_BC(38.5%,47/122)、CRF67_01B(8.2%,10/122)、CRF68_01B(4.9%,6/122)、B(3.3%,4/122)、CRF08_BC(3.3%,4/122)、CRF55_01B(1.6%,2/122)、CRF85_BC(0.8%,1/122)andCRF52_01B(0.8%,1/122).A total of 60 pol gene sequences were used to generate 10 molecular transmission networks,with clustering rate 49.2%,and the largest transmission cluster was CRF07_BC.The logistic regression analysis results showed that married with spouse(compared with widowed spouse,OR=0.242,95%CI:0.0060-0.972),homosexual transmission(compared with heterosexual transmission,OR=2.113,95%CI:1.020-4.377),genotype CRF07_BC(compared with other CRFs,OR=5.972,95%CI:1.655-21.554)were more likely to enter the HIV-1 molecular transmission network and spread quickly in the network.Conclusion The diversity of HIV-1 among newly reported cases were circulating in Huai'an,and there was a risk of drug-resistant strains in molecular transmission networks.Frequency of HIV-1 molecular epidemiological surveillance and baseline drug resistance monitoring should be carried out to prevent the further spread of drug resistant strains in the population.