广西崇左市扶绥县HIV-1分子传播网络特征分析

Analysis of HIV-1 molecular transmission network characteristics in Fusui County,Chongzuo City,Guangxi

目的:分析广西崇左市扶绥县艾滋病病毒(HIV)感染者的分子传播网络特征,并确定造成分子网络聚簇传播和高风险传播的危险因素。方法:采集崇左市扶绥县2005—2021年确诊的HIV/艾滋病(AIDS)患者血样。通过扩增HIV-1 pol区序列比对分析,构建分子传播网络。运用二元logistic回归分析入网和高危传播的影响因素。结果:本研究共获得扶绥县349条HIV-1 pol区序列,6种亚型,分别为CRF01_AE亚型(49.86%)、CRF07_BC亚型(32.38%)、CRF08_BC亚型(14.33%)、CRF55_01B亚型(1.14%)、C亚型(0.29%)、独特重组型(URF)(2.00%)。192条(55.01%)序列进入分子传播网络,形成31个簇、192个节点和736条边。年龄>50岁(a OR=1.861,95%CI:1.009~3.433)、感染CRF07_BC亚型毒株(a OR=4.386,95%CI:2.533~7.594)、文化程度为小学及以下(a OR=1.709,95%CI:1.070~2.729)、有非婚商业异性性接触史(a OR=1.682,95%CI:1.027~2.753),配偶或固定性伴阳性(a OR=2.428,95%CI:1.181~4.995)的患者更容易进入传播网络聚簇传播。年龄>50岁(a OR=1.861,95%CI:1.009~3.433),感染CRF07_BC亚型(a OR=4.386,95%CI:2.533~7.594),文化程度为小学及以下(a OR=1.699,95%CI:1.004~2.874)的患者更容易成为传播网络中的高连接者。结论:广西崇左市扶绥县AIDS传播的关键人群是年龄>50岁且文化程度为小学及以下的中老年人群,应针对重点人群的在分子网络中的传播聚簇特点进行溯源调查,并实施精准干预,减少二代传播。

Objective:To analyze the molecular transmission network characteristics of human immunodeficiency virus(HIV)-infected individuals in Fusui County,Chongzuo City,Guangxi,and to explore the risk factors contributing to network cluster and high-risk transmission.Methods:Blood samples were collected from HIV/AIDS patients diagnosed in Fusui County between 2005 and 2021.A molecular transmission network was constructed through comparative sequence analysis of amplified HIV-1 pol sequences.Binary logistic regression was used to analyze factors influencing entry into the molecular network and high-risk transmission.Results:In this study,a total of 349 HIV-1 pol sequences were analyzed,including 6 strain subtypes from Fusui County:CRF01_AE subtype(49.86%),CRF07_BC subtype(32.38%),CRF08_BC subtype(14.33%),CRF55_01B subtype(1.14%),C subtype(0.29%),and unique recombinant form(URF)(2.00%).Among the sequences,192(55.01%)sequences entered the molecular transmission network,forming 31 clusters,192 nodes,and 736 edges.Individuals aged over 50 years(aOR=1.861,95%CI:1.009-3.433),infected with the CRF07_BC subtype strain(aOR=4.386,95%CI:2.533-7.594),with education level of primary school or below(aOR=1.709,95%CI:1.070-2.729),with a history of non-marital commercial heterosexual contact(aOR=1.682,95%CI:1.027-2.753),and having a positive spouse/regular sexual partner(aOR=2.428,95%CI:1.181-4.995),were more likely to enter the transmission network for cluster transmission.Furthermore,individuals aged over 50 years(aOR=1.861,95%CI:1.009-3.433),infected with CRF07_BC(aOR=4.386,95%CI:2.533-7.594),and with education level of primary school or below(aOR=1.699,95%CI:1.004-2.874),were more likely to be high linkage transmission.Conclusion:The key population for AIDS transmission in Fusui County,Chongzuo City,Guangxi,is older adults aged over 50 years with a primary school education or below.It is important to conduct source tracing investigations based on the transmission clustering characteristics of key populations in the molecular network and implement targeted interventions to reduce secondary transmission.