彭州市2019-2021年新报告HIV-1感染者分子传播网络特征  

Molecular transmission network characteristics of newly reported HIV-1 infected patients in Pengzhou City,Sichuan Province,from 2019 to 2021

作　　者：何佳 袁丹[2] 李玲 李苑 李娜[4] 李一平 周玚 叶黎[2] 张灵麟[2] 钟霞 叶志华 梁姝[2] 杨义 HE Jia;YUAN Dan;LI Ling;LI Yuan;LI Na;LI Yiping;ZHOU Chang;YE Li;ZHANG Linglin;ZHONG Xia;YE Zhihua;LIANG Shu;YANG Yi(School of Management/Sichuan Institute of Health,Chengdu University of Traditional Chinese Medicine,Chengdu 611137,Sichuan,China;Sichuan Center for Disease Control and Prevention,Chengdu 610041,Sichuan,China;School of Public Health,Chengdu University of Traditional Chinese Medicine,Chengdu 611137,Sichuan,China;Pengzhou Center for Disease Control and Prevention,Pengzhou 611900,Sichuan,China)

机构地区：[1]成都中医药大学管理学院/健康四川研究院,成都611137 [2]四川省疾病预防控制中心,成都610041 [3]成都中医药大学公共卫生学院,成都611137 [4]彭州市疾病预防控制中心,四川彭州611900

出　　处：《中国艾滋病性病》2023年第7期751-756,共6页Chinese Journal of Aids & STD

基　　金：国家自然科学基金青年基金项目(81803300)。

摘　　要：目的分析四川省彭州市2019-2021年新报告HIV-1感染者分子网络特征,探讨网络形成的因素,为精准干预提供参考依据。方法2019-2021年共收集彭州市新报告HIV-1感染者血样592份,采用巢式PCR扩增法对HIV-1 pol基因区进行扩增和测序,对获得的基因序列构建最大似然法(ML)系统进化树并区分亚型,使用基因距离法构建分子传播网络。采用χ^(2)检验和Logistic回归分析入网的影响因素,并进行活跃分子簇分析。结果成功扩增得到565条序列,HIV亚型以CRF01_AE(286条,50.62%)和CRF07_BC(201条,35.58%)为主,其次为B(53条,9.38%)、CRF08_BC(18条,3.19%)、CRF55_01B(5条,0.88%)和C(2条,0.35%)亚型。共294条序列入网,入网率为52.04%(294/565),形成67个分子簇。Logistic回归分析显示:年龄≥50岁(OR=1.84,95%CI:1.09~3.10)、CRF01_AE和B亚型(OR=3.50,95%CI:2.29~5.34,OR=10.92,95%CI:4.61~25.87)、首次CD4细胞计数≥200个/μL(OR=2.25,95%CI:1.51~3.34)的感染者更容易入网。共形成4个活跃分子簇,簇内53.04%(61/115)的感染者有非婚商业异性性行为。结论四川省彭州市HIV传播来源多样化,分子网络近年扩张较快且呈现出明显的聚集性,农村地区低文化程度≥50岁男性是网络中的活跃人群,应加强对关键聚集性病例的溯源和商业异性性行为的干预。Objective To analyze the molecular network characteristics of newly reported HIV-1 patients in Pengzhou,Sichuan Province from 2019 to 2021,and explore the factors of network formation,so as to provide reference for precision intervention.Methods A total of 592 blood specimens of newly reported HIV-1 patients were collected from 2019-2021 in Pengzhou.Nested PCR was used to amplify and sequence the HIV-1 pol gene.Maximum likelihood(ML)phylogenetic tree was constructed for the obtained gene sequences and subtypes were identified.Molecular transmission network was constructed via gene-set distance analysis.Chi-square test and Logistic regression were used to analyze the influencing factors of network access,and active molecular cluster analysis was performed.Results Totally 565 sequences were amplified successfully.The primary HIV subtypes were CRF01_AE(286,50.62%)and CRF07_BC(201,35.58%),followed by B(53,9.38%),CRF08_BC(18,3.19%),CRF55_01B(5,0.88%)and C(2,0.35%).A total of 294 sequences accessed to the network,with an rate of 52.04%(294/565),and 67 molecular clusters were constructed.Logistic regression analysis showed that infected individuals aged≥50 years old(OR=1.84,95%CI:1.09-3.10),CRF01_AE and B subtypes(OR=3.50,95%CI:2.29-5.34,OR=10.92,95%CI:4.61-25.87),initial CD4 cell count≥200/μL(OR=2.25,95%CI:1.51-3.34)were more likely to access to the network.A total of 4 active molecular clusters were obtained,of which,53.04%(61/115)had non-marital commercial heterosexual sexual behaviors.Conclusions The source of HIV transmission is diversified in Pengzhou,Sichuan Province,and the molecular network has expanded rapidly and clustered obviously in recent years.Rural men aged≥50 years old with low education level are the active population in the network.It is necessary to strengthen the tracing for the source of crucial clusters and the intervention on commercial heterosexual sexual behaviors.

关 键 词：1型艾滋病病毒 分子网络 分子簇 活跃簇 

分 类 号：R373.9[医药卫生—病原生物学]