浙江省2013-2015年学生男男性行为人群HIV-1亚型与分子传播簇特征分析  

Characteristics of subtypes and transmission of HIV-1 infected persons among student MSM in Zhejiang province, 2013-2015

作　　者：丁晓贝[1] 潘晓红[1] 张佳峰[1] 何林[1] 蒋均[1] 范钦[1] 陈婉君 郑琳[2] 罗艳[3] 刘建宁[2] 郭志宏[1] 姚佳明 Ding Xiaobei;Pan Xiaohong;Zhang Jiafeng;He Lin;Jiang Jun;Fan Qin;Chen Wanjun;Zheng Lin;Luo Yan;Liu Jianning;Guo Zhihong;Yao Jiaming(Department of AIDS/STD Control and Prevention,Zhejiang Provincial Center for Disease Control and Prevention,Hangzhou 310051,China;Hangzhou Xihu District Center for Disease Control and Prevention,Hangzhou 310030,China;Department of AIDS/STD Control and Prevention,Hangzhou Prefectural Center for Disease Control and Prevention,Hangzhou 310021,China)

机构地区：[1]浙江省疾病预防控制中心艾滋病与性病预防控制所,杭州310051 [2]杭州市西湖区疾病预防控制中心,310030 [3]杭州市疾病预防控制中心艾滋病性病防治所,310021

出　　处：《中华流行病学杂志》2020年第6期940-945,共6页Chinese Journal of Epidemiology

基　　金：国家科技重大专项(2017ZX10201101)。

摘　　要：目的了解浙江省12~30岁学生MSM HIV-1亚型及传播簇的特征。方法以2013-2015年浙江省新确诊290例经男男性行为感染的学生HIV感染者(学生MSM感染者)为研究对象,开展HIV分子流行病学研究。收集流行病学相关信息,从采集的血浆中提取RNA,运用RT-PCR和巢式PCR扩增HIV-1的pol区基因,进行系统进化和分子传播簇分析。结果290例学生MSM感染者中,杭州市确诊的占50.3%,大专及以上文化程度占81.0%。成功获取178例序列,有10种亚型,以CRF01_AE(49.4%,88/178)和CRF07_BC(39.3%,70/178)亚型为主。共形成18个分子传播簇(簇大小:2~4例/簇),成簇比例为23.6%(42/178),簇内学生MSM感染者所在学校为同一县(区、市)的占61.9%(26/42),其性伴类型为学生和非学生并存。中学生MSM感染者的成簇比例为38.2%(13/34),高于大学生MSM感染者的成簇比例20.1%(29/144)(χ2=4.996,P<0.05)。结论2013-2015年浙江省学生MSM感染者的HIV-1亚型多样,提示HIV-1感染来源的多样化,HIV-1分子传播簇内的毒株呈现地理的相对聚集性,应加强性伴追踪和针对性干预,有效遏制艾滋病的传播。Objective To investigate the characteristics of subtype diversity and transmission on HIV-1 among 12 to 30 years old student MSM in Zhejiang province.Methods A total of 290 newly diagnosed HIV infected student MSM were selected as the research objects for molecular studies on HIV,in Zhejiang province during 2013 to 2015.Data on epidemiology and plasma samples of these people were collected.HIV-1 nucleotide sequences of pol gene regions were amplified using the RT-PCR/nested PCR method and sequenced.Phylogenetic analysis was performed to determine the HIV-1 genotypes.Characteristics of transmission mode among these cases were also analyzed.Results A total of 290 cases,50.3%were diagnosed in Hangzhou and 81.0%had college or above degrees.178 sequences including 10 subtypes,were obtained,with the main subtypes as CRF01_AE(49.4%,88/178)and CRF07_BC(39.3%,70/178).A total of 18 molecular transmission clusters were formed(42 cases,cluster size from 2 to 4),with the proportions of clusters as 23.6%(42/178).61.9%(26/42)of student MSM with their schools located in the same district within the transmission clusters.Their sexual partners would include both student MSM and non-student MSM.The proportion of clusters among middle school students was 38.2%(13/34),higher than that of college students(20.1%,29/144)(χ2=4.996,P<0.05).Conclusions The HIV-1 subtypes of student MSM in Zhejiang province appeared diversity,which indicated with the diversity of sources of infection.The geographical distribution of cluster cases is relatively centralized.In order to effectively control the spread of AIDS,more attention should be paid to the sexual partners involved and to specific programs on intervention.

关 键 词：艾滋病病毒1型 男男性行为人群 学生 分子传播簇 

分 类 号：R512.91[医药卫生—内科学] R181.3[医药卫生—临床医学]