2010-2012年北京市部分地区MSM中HIV-1急性期感染者的毒株亚型和流行状况  

Dynamics of HIV-1 subtypes among men who have sex with men during acute infection from 2010 to 2012 in Beijing area

作　　者：张志敏[1] 夏炜[2] 周月芳[2] 蒋岩[1] 吴昊[2] 冯凯迪 于凤娇[1] 粟斌[2] 邱茂锋[1] 

机构地区：[1]中国疾病预防控制中心性病艾滋病预防控制中心,北京102206 [2]首都医科大学附属北京佑安医院感染中心,北京100069

出　　处：《中国艾滋病性病》2017年第5期382-386,共5页Chinese Journal of Aids & STD

基　　金：北京市医院管理局临床医学发展专项经费(ZY201401);北京市艾滋病研究重点实验室(BZ0089);首都卫生发展科研专项基金项目(首发2016-1-2182);北京市科技计划资助(D141100000314002;D141100000314005);国家"十二五"科技重大专项(2012ZX10001001-001);中美艾滋病防治合作项目(2016-2017;4.2)~~

摘　　要：目的研究北京市男男性行为者(MSM)艾滋病病毒1型(HIV-1)感染者的毒株亚型、流行现状和变化规律。方法采用单纯随机抽样的方法,抽取北京佑安医院2010-2012年新发现的MSM HIV-1急性期感染者的血样共100人份,采样前均未进行抗病毒治疗。提取外周血单核细胞(PBMC)中的脱氧核糖核酸(DNA),用巢式聚合酶链式反应(PCR)扩增病毒env、gag和pol基因区序列,三区中如有扩增失败,则尝试提取血浆中的核糖核酸(RNA),反转录后进行巢式PCR扩增。PCR产物测序后进行基因亚型分析。计算pol基因区样本间基因离散率,并做系统进化树分析。结果有96份样本的基因序列扩增成功,检出的基因亚型有CRF01_AE、CRF07_BC、B、B′、CRF55_01B、CRF65_cpx和未知亚型,所占比例依次为42.7%、25.0%、15.6%、1.0%、1.0%、3.1%和11.5%。前3种亚型合计占83.3%。各亚型所占比例与相关文献相比有明显变化,表现为CRF07_BC亚型所占比例的快速上升和B亚型所占比例的显著下降。发现了新亚型CRF65_cpx、CRF55_01B和一些未知亚型。结论 2010-2012年,北京市MSM HIV-1急性期感染者的HIV-1毒株亚型分布与相关报道相比已经发生改变,建议对北京地区HIV-1毒株的流行和变异进行密切监测。Objective To study the subtypes, epidemic status and changing pattern of HIV-1 strains among men who have sex with men （MSM） in Beijing. Methods 100 acute HIV-1 infections among MSM were selected from Beijing You＇an Hospital from 2010 to 2012. None of them received antiretroviral therapy. Their blood specimens were collected, and then DNA was extracted from peripheral blood mononuclear cells （PBMC）. The viral env, gag and pol gene region fragments were amplified by nested polymerase chain reaction （ PCR ）, sequenced and analyzed for HIV-1 subtypes, and attempts were made to extract RNA from the plasma for further amplification when the amplification failed, and nested PCR was performed after reverse transcription. The gene distance between pol gene regions was calculated and phylogenetic tree analysis was performed. Results The subtypesCRF01_ AE, CRF07_BC, B, B＇, CRF55 01B, CRF65_cpx and unknown subtypes were detected among 96 acute HIV-1 infections in Beijing area, accounting for 42.7%, 25.0% 15.6%, 1.0%, 1.0%, 3.1% and 11.5 %, respectively. The main epidemic strains were subtypes CRF01_AE, CRF07_ BC and B, representing 83.3 % of the total. The proportion of these subtypes had obvious changes compared with the related literature, which showed a rapid increase of the proportion of CRF07 BC, a significant decrease of the proportion of subtype B, and the emergence of new subtypes such as CRF65_cpx and CRF55_01B, as well as some unknown subtypes. Conclusion The distribution of HIV-1 subtypes among MSM in Beijing has changed, compared with those relevant reports. Efforts should be made to closely monitor the prevalence and variation of HIV-1 strains in Beijing area.

关 键 词：艾滋病病毒1型 男男性行为者 基因亚型 系统进化树 

分 类 号：R512.91[医药卫生—内科学] R373.9[医药卫生—临床医学]