基于分子网络方法分析2009—2017年中缅边境未治疗16~25岁HIV-1感染者流行特征  

Analysis on characteristics of untreated 16-25 years old people living with HIV-1 at the China-Myanmar border from 2009 to 2017 based on molecular network method

作　　者：丁奕博 陈敏[2] 王继宝 冯毅[1] 甘梦泽 汪立杰 林倩茹 何林 马艳玲[2] 韩孟杰[1] 马丽英[1] Ding Yibo;Chen Min;Wang Jibao;Feng Yi;Gan Mengze;Wang Lijie;Lin Qianru;He Lin;Ma Yanling;Han Mengjie;Ma Liying(State Key Laboratory of Infectious Disease Prevention and Control,National Center for AIDS/STD Control and Prevention,Chinese Center for Disease Control and Prevention,Beijing 102206,China;Institute for AIDS/STD Control and Prevention,Yunnan Center for Disease Control and Prevention,Kunming 650022,China;Dehong Dai and Jingpo Autonomous Prefecture Center for Disease Control and Prevention,Mangshi 678400,China)

机构地区：[1]中国疾病预防控制中心性病艾滋病预防控制中心传染病预防控制国家重点实验室,北京102206 [2]云南省疾病预防控制中心性病艾滋病研究所,昆明650022 [3]德宏傣族景颇族自治州疾病预防控制中心,芒市678400

出　　处：《中华实验和临床病毒学杂志》2021年第2期124-129,共6页Chinese Journal of Experimental and Clinical Virology

基　　金：国家科技重大专项(2018ZX10101002-004-003)。

摘　　要：目的使用分子网络方法分析2009—2017年中缅边境的德宏州未治疗的16~25岁HIV-1感染者流行特征,为精准防控和降低HIV-1在德宏州的传播提供参考。方法筛选HIV-1感染者,静脉采血并分离血浆,提取RNA用以扩增HIV-1 pol区序列,使用HIV-TRACE程序构建分子网络并进行统计学分析。结果 573名入组感染者中,中国籍319名(55.67%)、缅甸籍254名(44.33%);男性351名(61%),女性222名(39%);异性性传播404名(HET,70.51%),注射毒品110名(PWID,19.20%),男男性行为者51名(MSM,8.9%);亚型包括独特重组型193个(33.68%)、流行重组型201个(CRF,35.1%)、C亚型156个(27.23%)、B亚型23个(4.01%)。通过HIV-TRACE构建的83个分子网络涉及249名感染者,86.7%的网络由CRF01AE,C或URF构成,49%为中缅混合网络(41/83),缅甸籍进入中缅混合网危险度高(AOR=2.676,p=0.002);中国籍男性PWID网络同配性为0.34,缅甸男性PWID为0.20,MSM为0.18。结论中缅边境德宏州存在潜在的HIV-1跨境传播风险;需注意MSM和缅甸籍男性PWID人群与其他传播途径混合传播的现象。Objective To analyze the epidemiological characteristics of untreated 16-25 years old people living with HIV-1(PLWH)in Dehong on the China-Myanmar border during 2009 to 2017,by using molecular network method and to provide references for precise prevention and reduction of the spread of HIV-1 in Dehong.Methods Screening people living with HIV-1,collecting blood sample and separating plasma,extracting RNA were performed to amplify HIV-1 pol sequence,construct molecular network by HIV-TRACE program and conduct statistical analysis.Results Among the 573 infected persons in the group,319 were Chinese(55.67%),254 were Burmese(44.33%);351 were males(61%),and 222 were females(39%);404 had heterosexual transmission(HET,70.51%),110 people injected drugs(PWID,19.20%),51 men had sex with men(MSM,8.9%);genotypes included 252 unique recombinant forms(43.98%),and 222 had circular recombinant forms(39.02%),76 had HIV-1 C(13.26%)and 23 HIV-1 B(4.01%)infection.The 83 molecular networks constructed through HIV-TRACE involved 250 PLWH,49%were the China-Myanmar mixed network(41/83).Myanmar citizens were at high risk of accessing the China-Myanmar mixed network(AOR=2.676,p=0.002).Chinese male PWID network assortativity is 0.34,Myanmar male PWID was 0.14,MSM was 0.12.Conclusions There is a continuous risk of cross-border transmission of HIV-1 in Dehong on the China-Myanmar border;attention should be paid to the mixed transmission of MSM and Myanmar male PWID populations with other transmission routes.

关 键 词：HIV-1 分子网络 同配性 中缅边境 

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