云南德宏傣族景颇族自治州2017—2019年新报告HIV感染者基因亚型分布特征分析  

HIV subtypes in newly reported HIV-infected cases in Dehong Prefecture of Yunnan Province during 2017 to 2019

作　　者：段星 张志一 王继宝 叶润华 杨锦 周素娟[2] 王译葵 杨涛 杨跃诚 唐仁海 何纳[2] 丁盈盈[2] 段松 DUAN Xing;ZHANG Zhiyi;WANG Jibao;YE Runhua;YANG Jin;ZHOU Sujuan;WANG Yikui;YANG Tao;YANG Yuecheng;TANG Renhai;HE Na;DING Yingying;DUAN Song(Department of STD and AIDS Prevention,Dehong Dai and Jingpo Autonomous Prefecture Center for Disease Control and Prevention,Mangshi,Yunnan 678400,China;Department of Epidemiology,School of Public Health,Key Laboratory of Public Health Safety,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,云南芒市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：《上海预防医学》2022年第9期835-841,共7页Shanghai Journal of Preventive Medicine

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】分析2017—2019年云南省德宏傣族景颇族自治州(简称“德宏州”)新报告人类免疫缺陷病毒(HIV)感染者基因亚型分布特征,探究HIV流行情况及亚型分布特征随时间的变化趋势。【方法】对德宏州2017—2019年新报告且血浆量>200μL的HIV感染者标本进行核酸抽提,使用反转录⁃聚合酶链反应(RT⁃PCR)方法对HIV的gag、env和pol基因进行逆转录扩增,并对扩增产物测序,根据上述3个基因测序结果进行亚型确定。【结果】2017—2019年德宏州共报告HIV感染者3287例,其中成功获得HIV的gag、env和pol基因亚型者1813例,主要优势亚型为C亚型(28.4%,515/1813)、BC重组亚型(22.0%,398/1813)和CRF01_AE亚型(18.1%,329/1813)。在中国籍与缅甸籍HIV感染者中均表现为B亚型、C亚型和CRF01_AE亚型所占构成比逐年下降,01/BC重组亚型、CRF07_BC亚型及CRF08_BC亚型的构成比逐年上升(χ^(2)=75.212,P<0.001)。中国籍与缅甸籍不同HIV基因亚型的HIV感染者性别、年龄、婚姻状态、民族、文化程度和传播途径方面的构成比差异均有统计学意义(均P<0.05)。【结论】德宏州HIV基因亚型分布随时间变化表现出更为复杂多样的特点,表现为BC重组亚型和独特重组型所占构成比明显增加。[Objective]To determine the trend and influencing factors of HIV subtypes in newly reported HIV/AIDS cases in Dehong Dai and Jingpo Autonomous Prefecture(Dehong Prefecture)from 2017 to 2019.[Methods]RNA extraction was conducted among newly reported HIV/AIDS cases in Dehong Prefecture from 2017 to 2019 whose plasma volume was more than 200μL.The gag,env and pol genes were amplified by using RT-PCR and then sequenced to determine the subtypes.[Results]A total of 3287 HIV-infected cases were newly reported in Dehong from 2017 to 2019.The HIV gag,env and pol genotypes were determined in 1813 cases.The major subtypes were subtype C(28.4%,515/1813),recombination form BC(22.0%,398/1813)and CRF_01AE(18.1%,329/1813).Furthermore,the proportion of subtype B,subtype C and CRF01_AE decreased over years,whereas 01/BC,CRF07_BC and CRF08_BC increased over years in both Chinese and Burmese patients(χ^(2)=75.212,P<0.001).There were significant differences in gender,age,marital status,ethnicity,educational level and transmission route among Chinese and Burmese HIV-infected cases with diverse HIV genotypes(all P<0.05).[Conclusion]HIV subtypes in Dehong change over time,which demonstrates that the proportion of BC recombinant subtypes and unique recombinant subtypes increased significantly.

关 键 词：人类免疫缺陷病毒 HIV感染者 基因亚型 重组基因亚型 

分 类 号：R183.9[医药卫生—流行病学]