云南省德宏州2015—2016年新报告HIV感染者主要亚型毒株的传播特征  

Molecular transmission networks of HIV major subtypes strains in Dehong prefecture in Yunnan province during 2015-2016

作　　者：段星[1] 陈晓晨 王继宝[1] 周素娟[2] 叶润华[1] 王译葵 杨锦[1] 杨涛[1] 杨跃诚[1] 姚仕堂[1] 段松[1] 何纳[2] DUAN Xing;CHEN Xiaochen;WANG Jibao;ZHOU Sujuan;YE Runhua;WANG Yikui;YANG Jing;YANG Tao;YANG Yuecheng;YAO Shitang;DUAN Song;HE Na(Dehong Prefecture Center for Disease Control and Prevention,Mangshi 678400,China;Department of Epidemiology,School of Public Health,and the Key Laboratory for Public Health Safety of Ministry of Education,Fudan University,Shanghai 200032)

机构地区：[1]德宏州疾病预防控制中心,云南芒市678400 [2]复旦大学公共卫生学院流行病学教研室公共卫生安全教育部重点实验室,上海200032

出　　处：《中国艾滋病性病》2019年第2期119-122,共4页Chinese Journal of Aids & STD

基　　金：国家重点地区艾滋病防治项目;国家科技重大专项(2013ZX10004-906);国家自然科学基金项目(81373062)~~

摘　　要：目的探讨云南省德宏州2015—2016年新报告艾滋病病毒(HIV)感染者主要亚型毒株的传播特征。方法对新报告HIV感染者进行血浆HIV病毒载量检测、扩增pol基因和测序,构建系统进化树、提取传播簇、选择最小基因距离构建HIV传播网络。结果中国籍与缅甸籍HIV感染者在年龄、婚姻、民族、文化程度、传播方式、基因亚型上的分布差异均有统计学意义(P<0.05)。227条CRF01_AE亚型pol区序列形成的传播网络中,其成簇率为33.0%(75/227);而在90条B亚型pol区序列和368条C亚型pol区序列形成的网络中,成簇率分别为54.4%(49/90)、70.7%(260/368)。感染CRF01_AE亚型毒株的人群中,男性成簇>10条序列为7.7%,女性为1.2%;缅甸籍为6.5%,中国籍为3.4%。感染C亚型毒株的人群中,>40岁成簇>10条序列的为29.1%,≤40岁为15.5%;中国籍为26.8%,缅甸籍为14.2%。此外研究发现,有患者的CRF01_AE亚型形成的传播网络"度"高达120,为超级传播者。结论在感染CRF01_AE亚型毒株的人群中,男性与缅甸籍更易形成大簇;在感染C亚型毒株的人群中,年龄>40岁、中国籍更易形成大簇。超级传播者在HIV感染者不同毒株的分子传播网络形成中都起到重要作用。Objective To explore the evolutionary dynamics and molecular transmission patterns of HIV-1 CRF01_AE,B,C in depth among 2015-2016 newly reported HIV infections in Dehong prefecture of Yunnan province.MethodsWe detected the viral load,amplified the pol gene and sequenced to construct the propagation network by building the phy-logenetic tree,extracting the transmission cluster and selecting the minimum gene distance.Results There were significantdifferences in the distribution of age,marriage,ethnicity,education level,transmission route and gene subtype betweenChinese and Burmese HIV-infected patients(P<0.05).Of 227 CRF01_AE sequences,its clustering rate was 33.0%(75/227).Of 90 Bsequences the clustering rate was 54.4%(49/90).Of 368 Csequences,the clustering rate was 70.7%(260/368).Compared with those in other parts of China,there was a large proportion of super-communicators in Dehongprefecture.Among the male and female infected persons of the CRF01_AE subtype stain,>10 sequences in the cluster ac-counted for 7.7% and 1.2%,respectively;meanwhile,Chinese and Burmese accounted for 3.4% and 6.5%,respectively.Among the infected people of >40 years oldand≤40 years old infected with subtype C strains,>10 sequences in the cluster accounted for 29.1%and 15.5%,respectively;and Chinese and Burmese accounted for 26.8% and 14.2%,respectively.In addition,the studyfound that the patients with CRF01_AE subtype formed anetwork of "degree" of up to 120,called super-spreader.Conclusion Among the people infected with CRF01_AEsubtype strains,males and Burmese are more likely to form larger clusters.Among those infected with subtype C strains,those aged >40 years and Chinese are more likely to form larger clusters.Super-spreaders play an important role in the for-mation of molecular transmission networks of different strains of HIV-infected individuals.

关 键 词：艾滋病病毒 传播网络 传播簇 超级传播者 

分 类 号：R373.9[医药卫生—病原生物学]