浙江省丽水市男男性行为人群HIV-1基因亚型和传播特征研究  

Subtypes and transmission characteristics of HIV-1 in men who have sex with men in Lishui, Zhejiang

作　　者：叶灵[1] 王晓光[1] 张佳峰[2] 陈秀英[1] 范钦[2] 叶碧峰[1] 丛迎[1] 黄晓蒙[1] Ye Ling;Wang Xiaoguang;Zhang Jiafeng;Chen Xiuying;Fan Qin;Ye Bifeng;Cong Ying;Huang Xiaomeng(Lishui Center for Disease Control and Prevention,Lishui 323000,Zhejiang,China;Zhejiang Provincial Center for Disease Control and Prevention,Hangzhou 310051,Zhejiang,China)

机构地区：[1]丽水市疾病预防控制中心,浙江丽水323000 [2]浙江省疾病预防控制中心,浙江杭州310051

出　　处：《疾病监测》2019年第8期715-720,共6页Disease Surveillance

基　　金：浙江省医药卫生科技计划(No.2019KY359);丽水市科技计划(No.2018RC15)~~

摘　　要：目的了解浙江省丽水市男男性行为人群(MSM)人类免疫缺陷病毒1型(HIV-1)基因亚型和传播特征。方法收集丽水市2015-2018年新确证且未经抗病毒治疗MSM HIV-1感染样本,扩增pol基因并测序,构建系统进化树分析基因亚型及成簇特征,通过CPR 6.0在线软件分析耐药情况。结果 105例样本成功获得89例合格序列,优势亚型为CRF01AE(49.4%,44/89)和CRF07BC(37.1%,33/89),其他包括B和CRF5501B各3例,CRF08BC、CRF5901B和独特重组型(01AE/BC)各2例。发现8个传播簇,总成簇比例为21.3%(19/89),其中7个传播簇与现住址为丽水市莲都区的病例有关(87.5%,7/8)。发现3例样本存在1个监测性耐药突变,分别为M46I、V106A、K103N,传播性耐药率为3.4%(3/89)。结论丽水市7种MSM HIV-1亚型共存,呈现多元化趋势,莲都区发挥关键传播作用,应加强监测并重点对传播簇病例开展靶向干预。耐药传播率处于低流行水平。Objective To understand the subtypes and transmission characteristics of HIV-1 in men who have sex with men(MSM) in Lishui of Zhejiang province. Methods Blood samples were collected from the newly-diagnosed HIV-1 infected MSM who received no antiviral therapy in Lishui during 2015–2018, pol gene was amplified and sequenced, the gene subtypes and transmission characteristics were analyzed by phylogenetic tree construction, at last mutations on drug resistance was analyzed with online software CPR 6.0. Results A total of 89 sequences were obtained successfully from 105 samples. The predominant subtypes were CRF01AE(49.4%,44/89) and CRF07BC(37.1%,33/89), others were B and CRF5501 B detected in 3 cases respectively and CRF08BC, CRF5901 B and URF(01AE/BC) detected in 2 cases respectively. Eight transmission clusters were found, with the total clustered rate of 21.3%(19/89). Seven clusters of transmission were associated with the cases who lived in Liandu district(87.5%, 7/8). Three surveillance drug resistance mutations(M46 I, V106 A, K103 N)were found respectively in three samples. The overall rate of transmitted drug resistance(TDR) was 3.4%(3/89). Conclusion There were 7 HIV-1 subtypes in Lishui, HIV-1 genetic diversity showed complexity trend, and the cases in Liandu district might play a central role in the spread of HIV. It is necessary to strengthen the surveillance and targeted intervention for the cases associated with major transmission clusters. However, the prevalence of TDR was at a low level.

关 键 词：人类免疫缺陷病毒1型 亚型 男男性行为人群 传播特征 

分 类 号：R512.9[医药卫生—内科学]