江西省部分地区HIV/AIDS病例HIV-1分子传播网络分析

HIV-1 molecular transmission network among HIV/AIDS patients in parts of Jiangxi Province

目的了解江西省部分地区艾滋病病毒感染者和艾滋病患者(HIV/AIDS)艾滋病病毒1型(HIV-1)分子传播网络特征,为指导艾滋病防控和干预提供依据。方法选择江西省上饶市、宜春市和赣州市2018年1—6月新报告的HIV/AIDS病例为研究对象,收集人口学信息和HIV感染途径等资料。采集全血样本提取HIV RNA,采用反转录PCR和巢式PCR扩增HIV-1 pol区基因并测序,构建系统进化树分析基因亚型,采用基因距离法构建分子传播网络,分析成簇情况和病例特征。结果成功扩增获得序列305条,男性231例,占75.74%;≥50岁184例,占60.33%;异性性接触感染288例,占94.43%。HIV-1基因亚型以CRF07_BC和CRF01_AE为主,分别占51.48%和29.18%;赣州市基因亚型种类最多,有8种。在1.0%的基因距离阈值下,共形成27个分子簇,107个节点和150条边,分子成簇率为35.08%。最大分子簇1个,涉及上饶市7个县(区)30例HIV/AIDS病例,均为CRF07_BC亚型,年龄为(63.03±9.46)岁,感染途径均为异性性接触;度值≥4的高传播风险病例17例,其中10例来自玉山县。结论江西省部分地区HIV-1亚型以CRF07_BC和CRF01_AE为主,赣州市HIV-1基因亚型呈现多样化,玉山县可能存在潜在传播风险点。

Objective To investigate the characteristics of HIV-1 molecular transmission network among HIV/AIDS patients in parts of Jiangxi Province,so as to provide insights into guiding AIDS prevention and intervention.Methods The HIV/AIDS patients newly reported from January to June 2018 in Shangrao City,Yichun City and Ganzhou City were recruited,and demographic information and infection routes were collected.Blood samples were obtained to extract HIV RNA,and HIV-1 pol gene was amplified and sequenced using reverse transcription PCR and nested PCR assays.Gene subtypes were analyzed by constructing a phylogenetic tree.Molecular transmission network was constructed using gene-set distance,and the clustering patterns and the characteristics of HIV/AIDS patients within the clusters were analyzed.Results A total of 305 pol gene sequences were obtained successfully,including 231 males(75.74%),184 patients aged 50 years and above(60.33%),and 288 patients with heterosexual contact(94.43%).The main subtypes were CRF07_BC and CRF01_AE,accounting for 51.48%and 29.18%,respectively.Ganzhou City had the most genetic subtypes,with 8 types.Under the 1.0%gene distance threshold,27 molecular clusters were established,with 107 nodes and 150 edges,and the molecular clustering rate was 35.08%.The largest molecular cluster involved 30 patients from 7 counties(districts)of Shangrao City.All of them were CRF07_BC subtypes,had an average age of(63.03±9.46)years,and were infected through heterosexual contact.Among the 17 patients with high transmission risk(degree value≥4),10 patients came from Yushan County.Conclusions The main subtypes of HIV-1 are CRF07_BC and CRF01_AE in parts of Jiangxi Province,and the subtypes in Ganzhou City are diversified.There may be potential transmission risk points in Yushan County.