西双版纳傣族自治州2009-2011年HIV分子流行病学分析  

Molecular epidemiology of HIV-1 in Xishuangbanna Dai Autonomous Prefecture from 2009 to 2011

作　　者：郭卫中[1] 范建华 陈颂[1] 康钧 赖春辉[1] 方华 于靓[1] 刀红 邓文娣[1] 周映云[1] 卢葳 

机构地区：[1]广州中医药大学热带医学研究所,广州510405 [2]西双版纳傣族自治州疾病预防控制中心,云南景洪666100 [3]法国国家发展研究院(IRD)中国部,北京100730

出　　处：《中国艾滋病性病》2012年第12期821-823,827,共4页Chinese Journal of Aids & STD

基　　金：国家自然科学基金项目(81073128)~~

摘　　要：目的对西双版纳傣族自治州的艾滋病病毒(HIV-1)感染者进行流行病学分析、病毒亚型的检测和耐药性突变的分析,为疫情控制提供依据。方法对2009年7月至2011年6月的348例HIV感染者进行流行病学调查及病毒载量和免疫学检测,并从其中随机抽取50例样本进行部分pol基因序列的测定,据此进行基因型别和耐药性突变的分析。结果 348例HIV感染者,性传播占91.4%;以青壮年感染者较多,其中20～49岁占84.4%;确诊时感染者CD4+T细胞绝对数为(381.0±233.6)个/mm3,病毒载量为(3.81±0.98)log10拷贝数/mL。对50例感染者pol基因测序发现,以欧美B亚型(占60.0%)和CRF08_BC亚型(占20.0%)、CRF01_AE亚型(占14.0%)最为多见。仅1例感染者(CRF08_BC型)检出了M461M蛋白酶抑制剂主要耐药性突变。结论西双版纳傣族自治州的HIV-1新发感染人数仍在快速增加,以性传播为主的趋势进一步明显;有可能发生了欧美B亚型的新流行;而耐药性突变株的流行不明显。Objective To perform the molecular epidemiological analysis of the human immunodeficiency virus type I （HIV-1） infected people in Xishuangbanna Dai Autonomous Prefecture, test the subtype of virus and analyze the drug resistance mutations, so as to provide evidence for the epidemic control. Methods Epidemiological investi- gations, viral loads and CD4 counts testing were conducted among 348 infected cases confirmed from July 2009 to June 2011, and 50 cases were selected randomly for the partial pol gene sequencing, HIV-1 ：subtypes and drug resistance mutations. Results Among 348 cases, 91.4% were infected through sexual contact, 84.4% of them were 20 to 49 years old. The average CD4 counts were （381.0±233.6） cells/mm3 , and viral loads were （3.81±0.98） log10 copies/mL. Pol gene sequencing showed that European B, CRF08_BC and CRF01_AE subtypes were the dominant types accounting for 60.0%, 20.0% and 14.0%, respectively. Additionally, few drug resistant muta tions were identified. Conclusions The number of newly diagnosed HIV-1 positive cases increases rapidly, and sexual transmission is the most predominant route. Newly epidemic of European B subtype has possibly happened; epidemic of drug resistant mutation is not obvious.

关 键 词：艾滋病病毒 流行病学 传播途径 亚型 耐药性突变 

分 类 号：R512.91[医药卫生—内科学]