贵州省HIV-1毒株亚型与艾滋病流行的关系研究  

Distribution of HIV-1 subtype and its relationship with HIV/AIDS epidemic in Guizhou province

作　　者：孙显光[1] 邢辉[2] 李志坚[1] 程春林[2] 张信辉[1] 申莉梅[1] 何翔[2] 

机构地区：[1]贵州省疾病预防控制中心艾滋病性病皮肤病防治研究所,贵阳550002 [2]中国疾病预防控制中心艾滋病预防控制中心

出　　处：《中华流行病学杂志》2011年第7期689-692,共4页Chinese Journal of Epidemiology

基　　金：贵州省“十一五”重点攻关社会发展资金项目（黔科合字[2006]-3051）

摘　　要：目的研究HIV-1毒株基因变异与艾滋病在贵州省快速传播之间的关系。方法在不同时间采集贵州省多个地区HIV-1感染者样本共190份，利用巢式PCR扩增gnu和gag基因并测定序列，采用MEGA4．0软件确定样本亚型并分析其与贵州省艾滋病流行之间的关系。结果贵州省HIV／AIDS的报告数从1998年的66例上升到2009年的8435例，7年增加16．38倍。在不同时间采集的样本中共检出B（9例）、B’（4例）、C（2例）、CRF07BC（75例）、CRF08BC（17例）、CRF01AE（64例）等多种亚型的HIV-1毒株；CRF07BC、CRF08BC的eM基因离散率在传播过程中基因多态性不断增大（0．035±0．006→0．092±0．011）。贵州省HIV亚型1998年以B’亚型（4／11）为主，2002年以CRF07BC亚型（26／41）为主，而2007年以CRF01AE（62／119）为主，亚型分布的变化与近年来贵州省艾滋病流行呈现快速上升趋势及2001--2006年以吸毒传播感染为主（吸毒传播感染2610例、性传播感染176例）、2006年后性传播感染人数开始急速上升（吸毒传播感染1713例、性传播感染1833例）的特点有直接关系，HIV主要流行毒株的变化与传播途径高度相关（Z2=41．253，P=0．000）。结论不同亚型毒株随时间和主要感染途径的改变而成为当地的主要流行株，性传播人群是贵州省艾滋病防控的重点。Objective To study the HIV-1 diversity and how did it promot the rapid spread of AIDS, in Guizhou province. Methods A total of 190 HIV-1 positive subjects were collected in different years and regions from Guizhou province. The env and gag genes were amplified with nested PCR and their sequences were determined. The subtypes were identified by the MEGA 4.0 software and the relationships between subtypes and AIDS epidemic were analyzed. Results The number of HIV/AIDS reported cases was increased from 66 in 1998 up to 8435 in 2009, a 16.38 time increase in 7 years. Subtypes B （9）, B＇ （4）, C （2）, CRF07_BC （75）, CRF08_BC （17）, CRF01_AE （64） were identified in Guizhou province among the samples collected in various periods of time. The genetic diversities in env gene of CRF07_BC and CRF08_BC increased along with the spreading of HIV （from 0.035 ＋ 0.006 to 0.092 ＋ 0.011）. Subtype B＇ （4/11） appeared the main subtype prevailed in Guizhou in 1998 as well as CRF07 BC （26/41 ） in 2002 and CRF01 AE （62/119 ） in 2007. The HIV/ AIDS epidemic in Guizhou province showed an rapidly upward trend, with the main risk factors of HIV transmission as 2610 cases through injecting drug users （IDUs）. and 176 cases due to sexually transmitted infections （STIs）, from year 2001 to 2006. However, STIs began to increase rapidly, after 2006, with 1713 cases of IDUs and 1833 cases of STIs. Data indicated that the change of composition of different HIV-1 subtypes was correlated with the mode of transmission in Guizhou province （X^2=41.253,P=0.000）. Conclusion The types of HIV strains changed over time as well the turnover of the main risk factors. Sexual transmission, including both hetero- and homo-sexual became the main risk factors, suggesting the development of related prevention and control programs, on HIV/AIDS should be considered accordingly in the future.

关 键 词：艾滋病 艾滋病病毒 亚型 

分 类 号：R512.91[医药卫生—内科学]