浙江省2015年HIV分子亚型特征及其传播关系研究  

Molecular epidemiology and transmission of HIV-1 infection in Zhejiang province, 2015

作　　者：杨介者[1] 陈婉君 张文君[1] 何林[1] 张佳峰[1] 潘晓红[1] 

机构地区：[1]浙江省疾病预防控制中心性病艾滋病预防控制所,杭州310051

出　　处：《中华流行病学杂志》2017年第11期1551-1556,共6页Chinese Journal of Epidemiology

基　　金：基金项目：国家科技重大专项（2012ZX10001-001,2012ZX10001-002）;浙江省医药卫生科技计划（2016RCB004）

摘　　要：目的 了解浙江省现阶段HIV毒株亚型流行分布特征和分子网络传播关系.方法 采用分层随机抽样方法抽取浙江省2015年4-6月新发现HIV感染者302例进行横断面调查,运用RT-PCR和巢式PCR扩增pol基因成功获得276份序列,结合流行病学调查数据开展测序及系统进化树分析.结果 276例HIV感染者毒株亚型构成：CRF07_BC 122例（44.2%）,CRF01_AE 103例（37.3%）,CRF08_BC 17例（6.1%）,B亚型9例（3.2%）,CRF55_01B 6例（2.2%）,C亚型5例（1.8%）,CRF59_01B 1例（0.4%）,CRF67_01B 1例（0.4%）,A1亚型1例（0.4%）,URFs 11例（4.0%）.CRF07_BC、CRF01_AE毒株亚型在进化树上已形成明显的分簇现象,传播簇主要集中分布在MSM人群（76.5%）.MSM人群的成簇比例高于其他人群,且不同传播途径感染人群存在传播联系.结论 2015年浙江省HIV主要流行毒株以CRF07_BC、CRF01_AE为主,亚型构成有复杂化趋势,应加强对HIV毒株亚型和流行簇的监控和预警,开展分类管理,针对高风险人群和传播链开展有效防控.Objective To understand the distribution of HIV-1 subtype diversity and its transmission characteristics in Zhejiang province. Methods A total of 302 newly diagnosed HIV-1 positive patients were selected through stratified random sampling in Zhejiang in 2015. HIV-1 pol genes were sequenced successfully with reverse transcription PCR/nested PCR and phylogenetic analysis was conducted for 276 patients. Then a molecular epidemiologic study was performed combined with field epidemiological investigation. Results Of 276 sequence samples analyzed, 122 CRF07_BC strains （44.2%）, 103 CRF01_AE strains （37.3%）, 17 CRF08_BC strains （6.1%）, 9 B strains （3.2%）, 6 CRF55_01B strains （2.2%）, 5 C strains （1.8%）, 1 CRF59_01B strain （0.4%）, 1 CRF67_01B strain （0.4%）, 1 A1 strain （0.4%）, and 11 URFs strains （4.0%） were identified. Phylogenetic analysis revealed 16 clusters with only 15.1% （34/225） sequences involved among CRF07_BC and CRF01_AE strains. The clustered cases in MSM were higher than that in populations with other transmission routes. And clusters existed between the populations with different transmission routes. Conclusion The major strains of HIV-1 in Zhejiang are CRF07_BC and CRF01_AE. The HIV subtypes showed more complexity in Zhejiang. It is necessary to strengthen the surveillance for HIV subtypes, carry out classified management and conduct effective prevention and control in the population at high risk.

关 键 词：艾滋病病毒 亚型 传播关系 

分 类 号：R512.91[医药卫生—内科学]