中国三省份未治疗HIV-1感染者临床毒株分离及其独特重组型的特征  

Analysis on characteristics of virus isolation and unique recombinant forms from untreated HIV-1 infected patients in three provinces of China

作　　者：汪立杰[1] 冯毅[1] 何林 辛若雷[2] 王彦 梁姝[3] 丁奕博 梁淑家[4] 张媛媛[1] 胡彩琴 阮玉华[1] 邢辉[1] 洪坤学[1] 邵一鸣 马丽英 Wang Lijie;Feng Yi;He Lin;Xin Ruolei;Wang Yan;Liang Shu;Ding Yibo;Liang Shujia;Zhang Yuanyuan;Hu Caiqin;Ruan Yuhua;Xing Hui;Hong Kunxue;Shao Yiming;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,Beijing Center for Disease Control and Prevention,Beijing 100013,China;Center for AIDS/STD Control and Prevention,Sichuan Center for Disease Control and Prevention,Chengdu 610041,China;Guangxi Key Laboratory of AIDS Prevention and Control and Achievement Transformation,Guangxi Center for Disease Control and Prevention,Nanning 530021,China)

机构地区：[1]中国疾病预防控制中心艾滋病性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]北京市疾病预防控制中心艾滋病性病预防控制研究所,北京100013 [3]四川省疾病预防控制中心艾滋病性病预防控制中心,成都610041 [4]广西壮族自治区疾病预防控制中心艾滋病防治与成果转化重点实验室,南宁530021

出　　处：《中华实验和临床病毒学杂志》2022年第3期263-269,共7页Chinese Journal of Experimental and Clinical Virology

基　　金：国家自然科学基金(81871694,81773447);传染病预防控制国家重点实验室项目(2011SKIDLI102)。

摘　　要：目的分析未治疗的经性传播和注射吸毒感染HIV-1患者的病毒分离特征和独特重组型特征,为了解不同传播途径感染HIV-1的病毒生物学特性和精准防控提供依据。方法根据不同的HIV-1传播风险,筛选北京、广西、四川3个省市新诊断未治疗的HIV-1患者,静脉采血检测病毒载量、CD4^(+)T细胞计数,以及分离外周血淋巴细胞进行病毒分离,从病毒培养上清中提取RNA扩增全长序列,对序列进行分析。结果65名HIV-1感染者中,经男男性行为、异性性行为和注射吸毒感染分别为32(49.2%)、20(30.8%)和13(20.0%)例;亚型主要包括:26例(40.0%)CRF07C、23例(35.4%)CRF01E、9例(13.8%)独特重组型。共分离到46株HIV-1临床毒株,HIV-1分离阳性率与CD4^(+)T细胞显著负相关(χ^(2)=4.22,P=0.04),而与病毒载量正相关(χ^(2)=22.4,P<0.001);HIV-1的P24抗原含量多因素广义估计方程模型分析呈现类似结果。此外,广义估计方程模型显示P24抗原含量与培养时间正相关(52.14,95%CI:9.42~94.87,P=0.017),病毒生长曲线分析显示,在培养后第14天,男男性行为感染者的病毒P24抗原水平显著高于异性性行为和注射吸毒感染者(调整后P值分别为P<0.01和P<0.05)。9株独特重组型病毒均来自性传播感染者,男男性行为感染者中独特重组型的比例高于异性性行为感染者中的比例,且男男性行为感染者中的病毒基因重组断点多于异性性行为感染者。结论男男性行为感染者的血样对HIV-1病毒分离更敏感;性传播人群具有独特重组型多样性的特征,尤其是男男性行为感染者病毒基因重组更为明显。Objective To analyze the characteristics of viral isolation and unique recombinant from untreated HIV-1 patients infected through sexual transmission and injection drug use,so as to provide evidence for understanding the biological characteristics and precise prevention and control of HIV-1 infection in different transmission routes.Methods In view of the different HIV-1 transmission risks,newly diagnosed untreated HIV-1 patients from Beijing,Guangxi and Sichuan were carefully selected.Venous blood was collected to detect the viral load and CD4^(+)T cell count,and peripheral blood lymphocytes were isolated for virus isolation.Viral RNAs were extracted from the virus supernatant,and the near full-length genome sequences were obtained using in-house method,then the recombination patterns were determined.Results Among the 65 HIV-1 infection,32(49.2%),20(30.8%)and 13(20.0%)were infected via men who have sex with men(MSM),heterosexual and injection drug use(IDU),respectively;genotypes mainly included 26(40.0%)CRF07_BC,23(35.4%)CRF01_AE,and 9(13.8%)unique recombinant types(URFs).A total of 46 HIV-1 clinical strains were isolated.The positive rate of HIV-1 isolation was significantly negatively correlated with CD4^(+)T cells(χ^(2)=4.22,P=0.04),but positively correlated with viral load(χ^(2)=22.4,P<0.001);the multi-variate generalized estimating equations(GEE)model analysis of HIV-1 P24 antigen content showed similar result.In addition,GEE model showed a positive correlation between viral P24 antigen content and virus-producing culture time(52.14,95%CI:9.42~94.87,P=0.017).Viral growth curve analysis showed that the level of viral P24 antigen in MSM Group was significantly higher than that in heterosexual group and IDU group(adjusted P values were p<0.01 and P<0.05,respectively),on the 14th day after culture.The proportion of URFs in MSM Group was higher than that in heterosexual group,and the recombinant breakpoints in MSM Group were more than that in heterosexual group.Conclusions MSM population was more sensitive to

关 键 词：HIV-1 传播途径 男男性行为 病毒分离 独特重组型 

分 类 号：R512.91[医药卫生—内科学]