广西壮族自治区低档场所中老年嫖客与暗娼HIV-1感染者基因亚型研究  

Study on HIV-1 subtype among elderly male clients and female sex workers of low-cost venues in Guangxi Zhuang Autonomous Region, China

作　　者：邓月琴[1] 李剑军[2] 方宁烨[2] 王斌[2] 王江伟[2] 梁淑家[2] 沈智勇[2] 蓝光华[2] 张鸿满[2] 吴兴华[2] 陆华湘[2] 葛宪民[1,2] 

机构地区：[1]广西医科大学公共卫生学院劳动卫生与环境卫生学教研室,南宁530023 [2]广西壮族自治区疾病预防控制中心艾滋病防制所,南宁530028

出　　处：《中华流行病学杂志》2017年第3期326-330,共5页Chinese Journal of Epidemiology

基　　金：国家科技重大专项（2012ZX10004910）;广西八桂学者艾滋病防控关键技术岗位专项;国家自然科学基金（81360442,81460510）志谢感谢广西壮族自治区13个调查点各CDC的支持和协作

摘　　要：目的了解广西壮族自治区低档场所中老年嫖客与暗娼的HIV-1感染者病毒基因亚型特征及传播规律。方法采用方便抽样的方法，于2012年对广西壮族自治区4个城市和9个县（区）低档场所的嫖客（年龄≥50岁）与暗娼开展分子流行病学调查，进行HIV-1抗体筛查，对HIV-1抗体阳性者血浆进行pol区基因片段扩增和序列测定，对获得的基因序列进行系统进化树构建并鉴定毒株的基因亚型，分析毒株亚型分布特征及传播规律。结果共招募4048例中老年嫖客和784例低档暗娼，共发现116例HIV-1抗体阳性，中老年嫖客与暗娼的HIV-1抗体阳性检出率分别为2．5％（103／4048）、1．7％（13／784），对其中84例HIV-1抗体阳性者进行基因扩增和序列测定，53例获得基因序列（中老年嫖客48例、暗娼5例）。发现3种基因亚型，均为重组株，CRF01_AE占90．6％（48／53），CRF08_BC占7．5％（4／53），CRF07_BC占1．9％（1／53）。经系统进化树分析发现，48例CRF01_AE流行毒株聚集成2个传播簇Cluster1和2；4例CRF08_BC聚集成1个传播簇。在CRF01_AECluster1中又形成4个亚簇C1-SC1、2、3、4，各亚簇对象来源于同一处或相邻低档场所、或与同一省道毗邻乡镇的低档场所。结论广西壮族自治区低档场所中老年嫖客与暗娼HIV-1感染者流行毒株仍以CRF01AE为主，以同一处或相邻低档场所或毗邻乡镇呈小范围聚集，当地HIV-1阳性的中老年嫖客与暗娼可能是该人群易感者毒株快速传播的重要传染源。Objective To understand HIV-1 subtype characteristics and transmission clusters in elderly male clients and female sex workers （FSWs） of low-cost commercial sex venues in Guangxi Zhuang Autonomous Region, China. Methods A cross sectional survey was conducted in FSWs and elderly male clients （≥50 years） of low-cost commercial sex venues in 4 cities and 9 counties in Guangxi Zhuang Autonomous Region by convenient sampling in 2012. The blood sample was collected from each case for HIV-1 antibody detection. The pol gene fragments were amplified and sequenced from viral RNA template extracted from plasma samples. The phylogenetic tree was constructed and the subtypes were identified. Results A total of 4 048 elderly male clients and 784 FSWs were surveyed, and 116 HIV-1 infections were detected, the positive rate was 2.5%（103/4 048） in the clients and 1.7%（13/784） in FSWs. The gene amplification and sequencing of HIV-1 detected in 84 blood samples indicated that 53 pol gene sequences were successfully determined （48 blood samples from elderly male clients and 5 blood samples from FSWs）. Among 53 pol sequences, 48 （90.6%）, 4（7.5% ）, and 1（1.9% ） sequences were identified as CRF01_AE, CRF08_BC, and CRF07_BC, respectively. Two transmission clusters were identified among CRF01_AE, including 4 sub-clusters. One transmission cluster was identified among CRF08_BC. The transmission cluster or sub-cluster were from the infected individuals at same low-cost commercial sex venue, or different low-cost commercial sex venues in the same town, or same place, or adjacent villages and towns. Conclusions CRF01 AE was the predominant HIV-1 subtype among elderly male clients and FSWs of low-cost commercial sex venues in Guangxi Zhuang Autonomous Region, circulating in same venue or adjacent villages and towns. The HIV-1 positive male clients and FSWs might play an important role in the spread of the strains.

关 键 词：艾滋病病毒 基因亚型 传播簇 嫖客 暗娼 

分 类 号：R512.91[医药卫生—内科学]