广东省2016-2021年四类哨点监测人群HIV-1亚型分布及变化

HIV-1 subtype distribution and changes in four kinds of sentinel surveillance population in Guangdong Province from 2016 to 2021

目的研究2016-2021年广东省MSM、性病门诊男性就诊者(STD)、吸毒者(DUS)、暗娼(FSW)四类哨点监测人群HIV-1亚型分布及变化情况,探讨哨点监测同时开展分子流行病学监测的可行性。方法运用巢式PCR扩增HIV-1 pol区基因片段,鉴定基因亚型,并比较不同年份的HIV-1亚型变化。结果共计纳入分析814人。HIV-1主要流行亚型为CRF07_BC(43.2%,352/814)、CRF01_AE(27.5%,224/814)和CRF55_01B(14.9%,121/814),其他亚型占14.4%(117/814),其中CRF01_AE总体呈下降趋势,从2016年的33.9%下降到2021年的16.7%(χ_(趋势)^(2)=4.579,P=0.032);CRF07_BC和CRF55_01B在2016至2021年的趋势变化差异无统计学意义,但其构成比出现增加;存在一定比例CRF01_AE和CRF07_BC的新型重组毒株。结论2016-2021年广东省四类哨点监测人群HIV-1亚型分布以CRF07_BC、CRF01_AE和CRF55_01B为主,亚型复杂多样。CRF01_AE亚型的构成比呈下降趋势,并出现一定比例的新型重组毒株,值得重点关注。

Objective To explore the feasibility of simultaneously carrying out the sentinel surveillance and molecular epidemiological surveillance by studying HIV-1 subtype distribution and changes in four key populations under sentinel surveillance in Guangdong Province from 2016 to 2021,including men who have sex with men(MSM),men with sexually transmitted diseases(STD),drug users(DUs),and female sex workers(FSW).Methods Nested PCR was used to amplify the HIV-1 pol gene to identify HIV genotypes.HIV-1 subtype changes were compared over the study years.Results A total of 814 individuals were enrolled.The majority of HIV-1 subtypes were CRF07_BC(43.2%,352/814),CRF01_AE(27.5%,224/814),and CRF55_01B(14.9%,121/814).The overall trend of CRF01_AE was decreasing,with a constituent ratio dropping from 33.9%in 2016 to 16.7%in 2021(χ2 trend=4.579,P=0.032).From 2016 to 2021,there was no statistically significant difference in the trend of changes of CRF07_BC and CRF55_01B,even though an increased constituent ratio was observed.We also observed novel recombinant strains of CRF01_AE and CRF07_BC.Conclusions From 2016 to 2021,HIV-1 subtypes were complicated and diverse.The majority of subtypes were CRF07_BC,CRF01_AE,and CRF55_01B in four key populations under sentinel surveillance in Guangdong Province.The constituent ratios of CRF01_AE subtypes were decreasing,and some new recombinant strains appeared,which indicated that more research is needed.