嘉兴市男男同性传播HIV-1感染人群分子流行特征分析  

Molecular epidemiological characteristics of HIV-1 infection among men who have sex with men in Jiaxing City

作　　者：张晓飞 葛志坚 燕勇[1] 任港临 葛锐[1] 张倩倩[1] 张佳峰[2] 朱国英[1] Zhang Xiaofei;Ge Zhijian;Yan Yong;Ren Ganglin;Ge Rui;Zhang Qianqian;Zhang Jiafeng;Zhu Guoying(Jiaxing Key Laboratory of Pathogenic Microbiology,Jiaxing Center for Disease Control and Prevention,Jiaxing 314050,China;Department of HIV/AIDS&STD Control and Prevention,Zhejiang Provincial Center for Disease Control and Prevention,Hangzhou 310051,China)

机构地区：[1]嘉兴市疾病预防控制中心,嘉兴市病原微生物检测重点实验室,嘉兴314050 [2]浙江省疾病预防控制中心艾滋病与性病预防控制所,杭州310051

出　　处：《中华微生物学和免疫学杂志》2023年第12期977-985,共9页Chinese Journal of Microbiology and Immunology

基　　金：浙江省公益技术应用研究项目(LGF20H260002);嘉兴市病原微生物检测重点实验室建设基金。

摘　　要：目的了解嘉兴市男男同性传播人群(men who have sex with men,MSM)HIV-1型感染的分子流行特征,为防控提供方法和思路。方法回顾分析2020—2022年所有新报告MSM人群未经抗病毒治疗的病例血样,扩增HIV-1 pol基因,测序后使用MEGA v6.0软件分析核酸序列,构建系统进化树判断亚型,使用校正群体耐药分析程序(CPR)分析耐药突变,计算基因序列间遗传距离,使用Cytoscape v3.6.0软件绘制分子传播网络。结果共发现9种基因亚型,以CRF07_BC(43.3%)、CRF01_AE(36.9%)为主,未与参考亚型聚类的重组型病例占比5.0%。共检出耐药突变病例21例(7.0%),CRF07_BC和CRF01_AE亚型的耐药突变比率分别为8.2%和7.8%。蛋白酶抑制剂、核苷类逆转录酶抑制剂和非核苷类逆转录酶抑制剂的耐药突变检出率分别为1.7%、0.7%和4.7%。最适分子网络的基因距离为0.018,入网率43.3%,共形成38个分子簇(簇内2~26个节点)。同性性行为人数≥6,度值≥4的病例易进入活跃分子簇。TNS>0.75的高危传播病例以外省(市)户籍和商业服务业者为主要特征。重组型分子簇病例与外省病例有较高相似度。结论嘉兴地区MSM人群HIV-1亚型分布复杂,重组亚型检出率增高,传播耐药水平较高,活跃分子簇和高危传播病例人群多为商业服务类等外来人口,需加强监测和干预力度。Objective To investigate the molecular epidemiological characteristics of HIV-1 infection among men who have sex with men(MSM)in Jiaxing city,and provide methods and ideas for the prevention and control of HIV-1 infection.Methods This study retrospectively collected the blood samples from all newly reported cases of HIV-1 infection among MSM without antiviral treatment from 2020 to 2022.HIV-1 pol genes in the blood samples were amplified and sequenced.MEGA v6.0 software was used to analyze nucleic acid sequences.A phylogenetic tree was constructed to analyze HIV-1 subtypes.The calibrated population resistance program(CPR)was used to detect drug-resistant mutations.After calculating the genetic distance between gene sequences,molecular transmission networks were constructed using Cytoscape v3.6.0 software.Results A total of nine genetic subtypes were identified,with CRF07_BC(43.3%)and CRF01_AE(36.9%)accounting for the most.The recombinant forms that were not clustered with the reference subtype accounted for 5.0%.Drug-resistant mutations were identified in 21 cases(7.0%),and the mutation rates among strains of CRF07_BC and CRF01_AE subtypes were 8.2%and 7.8%,respectively.The detection rates of drug-resistant mutations to protease inhibitors,nucleoside reverse transcriptase inhibitors and non-nucleoside reverse transcriptase inhibitors were 1.7%,0.7%and 4.7%,respectively.The optimal genetic distance threshold of the molecular network was 0.018.At this genetic distance,the molecular network access rate was 43.3%,and 38 molecular clusters(ranging from 2 to 26 nodes per cluster)were included.Cases with≥6 homosexual partners and a degree value of≥4 were more likely to access the active molecular cluster.The population of high-risk transmission cases with TNS>0.75 were mainly nonlocal residents and commercial service providers.The recombinant forms showed high similarity in sequences with the strains from other provinces.Conclusions The distribution of HIV-1 subtypes in MSM in Jiaxing city was complex.Given the incr

关 键 词：HIV MSM 亚型 分子传播网络 传播特征 

分 类 号：R512.91[医药卫生—内科学] R181.3[医药卫生—临床医学]