德宏傣族景颇族自治州2017—2019年新报告HIV合并HCV感染者中HCV基因亚型的分子传播簇分析  

Molecular transmission clusters on HCV genotypes among newly reported HIV combined HCV infections in Dehong Dai and Jingpo Autonomous Prefecture of Yunnan province of China during 2017 and 2019

作　　者：王译葵 张志一[2] 杨锦 项丽芬 高洁 周素娟 王继宝 段星 杨涛 丁盈盈[2] 何纳[2] 段松 WANG Yi-kui;ZHANG Zhi-yi;YANG Jin;XIANG Li-fen;GAO Jie;ZHOU Su-juan;WANG Ji-bao;DUAN Xing;YANG Tao;DING Ying-ying;HE Na;DUAN Song(Center for Disease Control and Prevention of Dehong Dai and Jingpo Autonomous Prefecture,Mangshi,Yunnan 678400,China;不详)

机构地区：[1]德宏傣族景颇族自治州疾病预防控制中心,云南芒市678400 [2]复旦大学,上海200032

出　　处：《中国病毒病杂志》2021年第5期341-346,共6页Chinese Journal of Viral Diseases

基　　金：国家科技重大专项(2018ZX10715006-001,2018ZX10721102-004);国家重点地区艾滋病防治项目(卫办疾控发[2004]49号)。

摘　　要：目的了解云南省德宏傣族景颇族自治州(德宏州)2017—2019年新报告人类免疫缺陷病毒(human immune deficiency virus,HIV)合并丙型肝炎病毒(hepatitis C virus,HCV)感染者中HCV主要亚型的分子传播簇成簇情况及影响因素。方法通过"艾滋病综合防治信息系统HIV/AIDS病例报告板块"下载2017—2019年德宏州新报告HIV合并HCV感染者的基本信息,选取血浆量≥200μl的感染者血浆样本,对HCV的基因片段进行巢式PCR扩增,将序列进行拼接、比对和分型后,分别使用Mega7.0和Gephi构建系统进化树和分子传播网络。结果2017—2019年云南省德宏州共收集到新发HIV合并HCV感染者1137例,其中,949份感染者的血浆样本≥200μl,对其进行核酸扩增与测序。成功扩增并拼接的样本共620份。共发现HCV基因亚型15种,并发现疑似重组亚型11例。依据NS5B基因扩增区构建HCV分子传播网络,总成簇率为74.1%(390/526)。结果显示,与3b亚型相比,1a(OR=3.23,95%CI:1.53~6.82)和6u(OR=4.15,95%CI:1.87~9.22)亚型较易形成传播簇;6n(OR=0.19,95%CI:0.10~0.36)和3a(OR=0.24,95%CI:0.12~0.48)亚型较难形成传播簇。女性(与男性比较,OR=0.29,95%CI:0.10~0.81)、除傣族和景颇族外的少数民族(与傣族比较,OR=0.45,95%CI:0.21~0.95)较难形成传播簇。结论德宏州HIV合并HCV感染者中的HCV基因型种类多样,性别、民族和HCV基因亚型是影响HCV是否能形成分子传播簇的主要因素。Objective To understand the molecular transmission clustering and influencing factors of major HCV subtypes in newly reported HIV combined HCV infections in Dehong Dai and Jingpo Autonomous Prefecture(Dehong Prefecture)from 2017 to 2019 in Yunnan province of China.Methods The basic information of HIV/HCV co-infected patients newly reported in Dehong Prefecture from 2017 to 2019 were downloaded through the"HIV/AIDS Case Report Section of Integrated AIDS Prevention and Control Information System".Nested PCR was used to amplify CE1 and NS5 B genes from more than 200μl plasma samples.After the sequences were spliced,aligned,and typed,Mega7.0 was used to construct phylogenetic tree and molecular transmission network.Results A total of 1137 HIV/HCV coinfected patients were reported in Dehong Prefecture during 2017—2019,and 949 plasma samples(≥200μl)of the newly reported cases were subjected to nested PCR.Totally 620 samples were successfully amplified.A total of 15 subtypes of HCV were found,and11 cases of suspected recombinant subtypes were observed.The total clustering rate was 74.1%(390/526).Results showed that compared with subtype 3 b,subtypes 1 a(OR=3.23,95%CI:1.53-6.82)and 6 u(OR=4.15,95%CI:1.87-9.22)were more likely to form transmission clusters;subtypes 6 n(OR=0.19,95%CI:0.10-0.36)and 3 a(OR=0.24,95%CI:0.12-0.48)were less likely to form transmission clusters.Female(compared with the male,OR=0.29,95%CI:0.10-0.81)and ethnic minorities except Dai and Jingpo(compared with the Dai,OR=0.45,95%CI:0.21-0.95)were more difficult to form transmission clusters.Conclusions The HCV genotypes of HIV/HCV co-infected cases in Dehong Prefecture are diverse.Gender,ethnicity and HCV genotypes are the main influencing factors for the formation of HCV molecular transmission clusters.

关 键 词：艾滋病病毒 丙型肝炎病毒 基因亚型 重组亚型 分子传播簇 传播网络 合并感染 

分 类 号：R373.21[医药卫生—病原生物学] R373.9[医药卫生—基础医学]