2016年至2019年德宏傣族景颇族自治州境内缅甸籍人类免疫缺陷病毒/丙型肝炎病毒合并感染者的双基因亚型分析  

Profiles of human immunodeficiency virus and hepatitis C virus genotypes among human immunodeficiency virus/hepatitis C virus co-infected Burmese patients from 2016 to 2019 in Dehong Dai and Jingpo Autonomous Prefecture

作　　者：王继宝 冯程 段星 王译葵 杨锦 叶润华 周素娟 杨涛 杨跃诚 姚仕堂 何纳[2] 丁盈盈 段松 Wang Jibao;Feng Cheng;Duan Xing;Wang Yikui;Yang Jin;Ye Runhua;Zhou Sujuan;Yang Tao;Yang Yuecheng;Yao Shitang;He Na;Ding Yingying;Duan Song(Department for STD and AIDS Prevention and Control,Dehong Dai and Jingpo Autonomous Prefecture Center for Disease Control and Prevention,Dehong Dai and Jingpo Autonomous Prefecture 678400,China;Department of Epidemiology,School of Public Health,Key Laboratory of Public Health Safety of Ministry of Education,Fudan University,Shanghai 200032,China)

机构地区：[1]德宏傣族景颇族自治州疾病预防控制中心艾滋病性病防制科,德宏傣族景颇族自治州678400 [2]复旦大学公共卫生学院流行病学教研室公共卫生安全教育部重点实验室,上海200032

出　　处：《中华传染病杂志》2022年第6期335-342,共8页Chinese Journal of Infectious Diseases

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

摘　　要：目的:了解2016年至2019年云南省德宏傣族景颇族自治州(以下简称"德宏州")境内新报告缅甸籍人类免疫缺陷病毒(human immunodeficiency virus,HIV)/丙型肝炎病毒(hepatitis C virus,HCV)合并感染者的HIV和HCV基因亚型分布特征。方法:通过全国艾滋病综合防治数据信息系统收集2016年1月至2019年12月德宏州境内新报告缅甸籍HIV/HCV合并感染者共1 289例,选取血浆样本留存量≥200 μL的996例患者进行HIV和HCV基因亚型检测。采用巢式聚合酶链反应分别扩增HIV pol基因区、HCV核心蛋白结合包膜蛋白(core protein-binding envelope protein, CE1)基因区和非结构蛋白5B(non-structural protein 5B, NS5 B)基因区,通过MEGA 7.0软件构建系统进化树,明确基因分型。统计学分析采用 χ^(2)检验,采用趋势 χ^(2)检验分析HIV和HCV基因亚型逐年变化趋势。 结果:996例HIV/HCV合并感染者中,554例(55.6%)成功扩增HIV和HCV基因片段并明确分型。HIV和HCV基因分型呈多样化。HIV基因亚型以C型和BC重组亚型为主,分别占40.3%(223/554)和33.6%(186/554);其次为B型、流行重组型(circulating recombinant form,CRF)01_AE型,分别占6.5%(36/554)和3.6%(20/554)。HCV基因亚型以3b型为主,占31.2%(173/554);其次为6u、1a、6n、3a、6xg型,分别占19.5%(108/554)、17.5%(97/554)、11.4%(63/554)、8.7%(48/554)、6.3%(35/554)。2016年至2019年HIV C型的构成比呈逐年下降趋势( χ趋势2=7.23, P<0.001),BC重组亚型呈上升趋势( χ趋势2=5.97, P<0.001)。2019年BC重组亚型构成比为54.9%(101/184),高于C型的21.7%(40/184)。2016年至2019年HCV 3b型、6u型、1a型的构成比无明显变化趋势( χ趋势2=1.43、1.79、0.39, P=0.152、0.074、0.695)。不同民族患者的HIV基因亚型分布差异有统计学意义( χ^(2)=22.06, P=0.037)。 结论:德宏州境内缅甸籍HIV/HCV合并感染者的HIV和HCV基因亚型种类复杂多样。其中,HIV BC重组亚型成为优势传播毒株的趋势显著,需要进一步加强对�Objective To investigate the distributions of human immunodeficiency virus(HIV)and hepatitis C virus(HCV)genotypes among newly reported HIV/HCV co-infected Burmese patients in Dehong Dai and Jingpo Autonomous Prefecture,Yunnan Province from 2016 to 2019.Methods A total of 1289 newly reported HIV/HCV co-infected Burmese patients in Dehong Dai and Jingpo Autonomous Prefecture were collected through the National Acquired Immunodeficiency Syndrome Comprehensive Prevention and Control Data Information System From January 2016 to December 2019.Among them,996 subjects with a plasma volume of≥200μL were selected to perform HIV and HCV genotyping.The HIV pol gene,the HCV core protein-binding envelope protein(CE1)gene and non-structural protein 5B(NS5B)gene were amplified using the nested polymerase chain reaction.The phylogenetic tree was constructed by MEGA 7.0 software to classify the genotypes.Chi-square test was used for statistical analysis.Trend chi-square test was used to analyze the trend of HIV and HCV genotypes.Results Among the 996 cases with HIV/HCV co-infection,HIV and HCV sequences from a total of 554 subjects(55.6%,554/996)were successfully obtained,and the genotypes of HIV and HCV were diverse.HIV genotype C(40.3%,223/554)and BC recombinant(33.6%,186/554)were the most prevalent,followed by genotype B(6.5%,36/554)and circulating recombinant form(CRF)01_AE(3.6%,20/554).HCV genotype 3b was the most prevalent(31.2%,173/554),followed by genotype 6u(19.5%,108/554),1a(17.5%,97/554),6n(11.4%,63/554),3a(8.7%,48/554)and 6xg(6.3%,35/554).The prevalence of HIV genotype C showed a downward trend(χtrend2=7.23,P<0.001),while the prevalence of BC recombinant showed an upward trend(χtrend2=5.97,P<0.001),and the proportion of BC recombinant was higher than genotype C in 2019(54.9%(101/184)vs 21.7%(40/184)).However,there were no statistically significant differences in the proportions of genotype 3b,6u and 1a from 2016 to 2019(χtrend2=1.43,1.79 and 0.39,respectively,P=0.152,0.074 and 0.695,respectively).The HIV genotyp

关 键 词：HIV 丙型肝炎病毒 合并感染 基因亚型 缅甸籍 

分 类 号：R512.91[医药卫生—内科学] R512.63[医药卫生—临床医学]