2015—2019年河北省HIV-1新发感染因素与基因亚型分析

Analyses of HIV-1 Recent Infectious Factors and Gene Subtypes in Hebei Province from 2015 to 2019,China

目的 了解河北省哨点监测人群中HIV-1感染趋势、新发感染因素和病毒基因分型。方法 使用趋势卡方检验分析2015—2019年哨点HIV-1阳性病例发展趋势;通过限制性抗原亲和力酶联免疫试验和in-house法分别进行HIV-1新发感染检测和基因型检测。采用多因素Logistic回归分析HIV-1新发感染影响因素。结果 2015—2019年间在24岁以下(P=0.047)、检测咨询(P<0.001)和专题调查(P<0.001)中的阳性病例呈现出明显上升趋势。MSM人群HIV-1新发感染率从2015年的4.2%上升到2017年的5.7%,后呈现明显下降趋势,到2019年下降到3.0%。MSM人群新发感染在25~49岁年龄段(P=0.017)、样本来源为专题调查(P=0.008)的人口社会学特征中差异有统计学意义。在哨点MSM人群中流行着10种基因亚型毒株,占比最高的为CRF01_AE 51.07%(335/656),其次是CRF07_BC 33.23%(218/656)、B 9.76%(64/656)、URFs 2.59%(17/656)、CRF55_01B 1.68%(11/656)、CRF08_BC 1.07%(7/656)、CRF65_cpx 0.15%(1/656)、CRF68_01B 0.15%(1/656)、CRF85_BC 0.15%(1/656)和C 0.15%(1/656)。5年间既往感染和新发感染CRF01_AE毒株(P=0.030)和CRF07_BC毒株(P=0.001)差异有统计学意义,而B亚型毒株(P=0.655)差异无统计学意义。结论 河北省MSM人群中HIV-1感染者的病毒基因亚型多样化,青壮年和检测咨询人群发生新感染的风险较高,建议重点加强此类人群的监测。

Objective To investigate the infection trend,recent infectious factors and genetic subtypes of HIV-1 at HIV sentinel surveillance points in Hebei Province,China.Methods From 2015 to 2019,the epidemic trend of HIV-1 infections at the HIV surveillance points was analyzed using χ~2-trend-test.The recent infection detection and genetic subtypes of HIV-1 were performed using limiting antigen avidity EIA(LAg EIA) and in-house method,respectively.Logistic regression analysis was used to estimate the potential factors related to HIV-1 recent infections among MSMs.Results The number of HIV-1 individuals with ≤ 24 years(P=0.047),counseling and testing(P<0.001) and specific survey(P<0.001) indicated the increasing trend within five years.HIV-1 incidence increased from 4.2% in 2015 to 5.7% in 2017,however dropped to 3.0% in 2019,and showed significant statistical differences among MSMs aged 25-49(P=0.017) and obtained from specific survey(P=0.008).Ten subtypes were identified among MSMs at the surveillance points.CRF01_AE was the most frequent,accounting for 51.07%(335/656),followed by CRF07_BC 33.23%(218/656),B 9.76%(64/656),URFs 2.59%(17/656),CRF55_01B 1.68%(11/656),CRF08_BC 1.07%(7/656),CRF65_cpx 0.15%(1/656),CRF68_01B 0.15%(1/656),CRF85_BC 0.15%(1/656) and C 0.15%(1/656).The distribution of CRF01_AE(P=0.030) and CRF07_BC(P=0.001) showed the statistical difference between HIV-1 long-term infection and recent infection during 2015 to 2019,respectively,while B(P=0.655) showed no difference.Conclusion HIV-1 genetic subtypes among MSMs are diversity and the young adults` recent infections are at higher risk,suggesting the surveillance of this population in recent infections should be strengthened.