应用分子流行病学调查一起HIV-1 CRF02_AG家庭内传播  

Molecular epidemiological investigation of an intra-familial transmission of HIV-1 CRF02_AG

作　　者：辛若雷[1] 刘安[2] 孙丽君[2] 李佳[1] 张琴[1] 卢红艳[1] 孙伟东[1] Xin Ruolei;Liu An;Sun Lijun;Li Jia;Zhang Qin;Lu Hongyan;Sun Weidong(Institute of STD/AIDS Prevention and Control,Beijing Municipal Center for Disease Prevention and Control,Beijing Center for Preventive Medicine Research,Beijing 100013,China;Center for STD/AIDS Diagnosisand Therapy,Beijing Youan Hospital,Capital Medical University,Beijing 100069,China)

机构地区：[1]北京市疾病预防控制中心北京市预防医学研究中心性病艾滋病防治所,100013 [2]首都医科大学附属北京佑安医院性病艾滋病诊疗中心,100069

出　　处：《国际病毒学杂志》2019年第1期21-25,共5页International Journal of Virology

基　　金：国家自然科学基金(81273136).

摘　　要：目的通过调查一起家庭内HIV-1传播事件,阐明家庭成员HIV-1毒株传播关系。方法通过流行病学调查方法,对1例HIV-1抗体筛查有反应孕产妇及其配偶和所育婴儿进行随访和检测。运用一步法逆转录-聚合酶链反应(RT-PCR)扩增HIV-1 gag基因和pol基因片段,构建系统进化树分析其进化传播关系。结果孕产妇(EID1107M)在孕期保健期间存在HIV抗体血清阳转现象。其丈夫(EID1107F)随后确诊为HIV-1抗体阳性;其所育婴儿(EID1107I)在出生后8个月HIV-1核酸检测阳性。3个病例均感染HIV-1 CRF02_AG毒株,进化树上聚集成可靠进化簇,拓扑学结构表明"父-母-子"之间的传播关系。结论加强婚前检查和孕期保健感染性疾病筛查,对阳性孕产妇病例实施及时有效的母婴阻断,避免传染性疾病的家庭内二代传播,提高出生人口质量。Objective To investigate an intra-familial transmission event of human immunodeficiency virus type 1 (HIV-1) using molecular epidemiological method, and to elucidate the spreading route among the family members. Methods Epidemiological investigation, including follow-up and testing, was conducted for a pregnant woman who was anti-HIV screening-reactive, her husband and their newborn. Viral RNA was extracted to amplify HIV-1 gag gene and pol gene segments with one-step RT-PCR. Phylogenetic tree was constructed to analyze the spreading route. Results The proband (EID1107M) was a pregnant woman who was found to be HIV-seropositive during pregnant care. Her husband (EID1107F) was then confirmed to be anti-HIV positive. Her newborn (EID1107I) was positive for HIV-1 nucleic acid at age of eight months. All three patients were infected with HIV-1 CRF02_AG strain. Phylogenetic tree showed that the three patients formed a subcluster with high genetic homogeneity. The topological structure indicated the transmission route was from the father to the mother, then to their child. Conclusion Contagious diseases screening should be reinforced before marriage and during pregnant care. Prevention of mother-to-child transmission should be timely and efficiently administered upon diagnosis of infection, to avoid the secondary intra-familial transmission and to improve the population quality at birth.

关 键 词：人免疫缺陷病毒1型 家庭内 母婴传播 分子流行病学 

分 类 号：R181.3[医药卫生—流行病学] R512.91[医药卫生—公共卫生与预防医学]