HIV-1／HCV合并感染者中HCV基因亚型流行情况调查  

The prevalence of hepatitis C virus （HCV） subtypes in Chinese HIV-1/HCV co-infected individuals

作　　者：刘静[1] 杨洋[2] 宫菊丽[3] 张子宁[1] 张旻[1] 王亚男[1] 姜拥军[1] 戚中田[2] 潘启超[3] 钟平[3] 尚红[1] 

机构地区：[1]中国医科大学附属第一医院卫生部艾滋病免疫学重点实验室,沈阳110001 [2]解放军第二军医大学微生物教研室 [3]上海市预防医学研究院艾滋病病毒免疫研究室

出　　处：《中华流行病学杂志》2009年第7期663-667,共5页Chinese Journal of Epidemiology

基　　金：国家科技重大专项课题（2008ZX10001-001）;卫生部艾滋病防治应用性研究项目（WA2006-02）;上海市医学重点学科建设项目（05Ⅲ029）

摘　　要：目的了解中国部分地区HIV-1和HCV合并感染人群中HCV基因亚型的流行、分布及其与HIV-1感染疾病进展的关系。方法对186份获自河南、云南、新疆、吉林和辽宁省HW-1／HCV合并感染人群标本（HCV病毒载量〉1000cop／ml），用反转录巢式聚合酶链反应方法扩增血浆HCV核心基因区并进行基因亚型分型，同时检测HIV-1和HCV载量以及CD4＋T细胞计数。结果（1）HCV不同基因亚型比例分别为1a（1．7％）、1b（39．9％）、2a（17．9％）、3a（10．4％）、3b（15．6％）、6a（1．2％）、6n（6．4％）和6型未鉴定亚型（7．5％）。HCV2a和1b主要流行于河南省既往有偿献血浆人员中；3a和3b亚型主要流行于新疆和云南静脉注射吸毒者（IDU）中；HCV6型主要流行于云南吸毒人员中。（2）1b亚型的HCVRNA水平显著高于非1b亚型，但在HIV-1载量和CD4＋T细胞数方面差异无统计学意义。2a亚型的HIV-IRNA和HCVRNA水平显著低于非2a亚型。结论HW-1／HCV合并感染人群中HCV基因亚型的流行和分布与流行地区和感染途径有关。新的HCV6型亚型病毒株已经在合并感染的IDU人群中流行。尚未发现HCV基因亚型与HIV感染疾病进展之间的关系。Objective To better understand the prevalence and geographic distribution of genotypes/subtypes on HCV and the relationship between HCV genotypes/subtypes and HIV infection disease progression in the HIV-1/HCV co-infected individuals living in high HIV-1 prevalent areas in China. Methods 186 plasma samples were collected from HIV-1 seropositive individuals infected through paid blood donors （PBD）, injecting drug users （IDUs） or sexual contact, living in most severely affected provinces, Henan, Yunnan, Xinjiang, Jilin and Liaoning provinces. Samples with HCV viral load 〉1000 cop/ml were amplified by RT-nested PCR, sequenced and phylogenetically analyzed for genotyping/subtyping of HCV. HIV-1, HCV viral loads and CD4^＋T lymphocytes were measured for all subjects. Results （1） HCV were identified as la （1.7%）, lb （39.9%）, 2a （17.9%）, 3a （10.4%）, 3b （15.6%）, 6a （1.2%）, 6n （6.4%）, and a newly unclassified subtype （7.5%）. HCV 2a and lb subtypes predominated in PBD in Henan, 3a and 3b in IDUs in Xinjiang and Yunnan, and 6 genotype/subtypes in IDU in Yunnan. （2） There were no significant differences in CD4^＋T cell counts among the different HCV subtypes. （3） The viral load of HCV RNA in lb subtype was higher than that of non-1b subtype, however, no significant differences in HIV-1 viral loads and CD4^T cell counts were found between lb and non-1b subtype. Both HIV and HCV viral loads were lower in 2a than non-2a subtype. Conclusion The prevalence of HCV genotype/subtype in HIV-1/HCV co-infected individuals was associated with geographic areas and transmission routes. HCV subtypes had no direct correlation with HIV infection disease progression.

关 键 词：丙型肝炎病毒 人免疫缺陷病毒 合并感染 基因亚型 

分 类 号：R512.91[医药卫生—内科学] R512.63[医药卫生—临床医学]