2010—2019年云南省德宏州新报告男男性行为HIV感染者病毒基因亚型分子传播网络分析  

HIV genotypes and molecular transmission networks among MSM with newly reported HIV infections in Dehong Prefecture,Yunnan Province from 2010 to 2019

作　　者：段星 梁欣悦 王继宝 杨锦 王译葵 杨宇珑 周素娟[2] 杨涛 杨跃诚 唐仁海 叶润华 丁盈盈[2] 何纳[2] 段松 DUAN Xing;LIANG Xinyue;WANG Jibao;YANG Jin;WANG Yikui;YANG Yulong;ZHOU Sujuan;YANG Tao;YANG Yuecheng;TANG Renhai;YE Runhua;DING Yingying;HE Na;DUAN Song(Department of AIDS and STD Prevention and Control,Dehong Dai and Jingpo Autonomous Prefecture Center for DiseaseControl and Prevention,Mangshi,Yunnan 678400,China;School of Public Health,Fudan University,Ministry of PublicHealth and Safety Education Key,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,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》2023年第12期1168-1174,共7页Shanghai Journal of Preventive Medicine

基　　金：国家科技重大专项(2018ZX10721102-004,2018ZX10715006-001);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】了解2010—2019年间德宏傣族景颇族自治州(德宏州)男男性行为人群(MSM)新报告人类免疫缺陷病毒(HIV)感染者的HIV主要亚型及其分子传播簇和流行病学特征,筛选疑似高危传播者,为传染源筛查、管理与干预提供参考依据。【方法】收集2010—2019年德宏州新报告男男性行为者HIV阳性血浆样本,扩增病毒pol基因区片段并进行基因测序和基因亚型确认,分析、计算两两序列间的基因距离,使用MEGA 7.0和Gephi进行系统进化分析、构建分子传播网络。【结果】2010—2019年德宏州新报告HIV感染者MSM159例,成功测定基因亚型的感染者100例。共有9种HIV‑1亚型,最主要亚型为CRF01_AE亚型52例(52%),其次为CRF07_BC亚型31例(31%)、CRF55_01B亚型10例(10%)、其他7例(7%)。传播簇分析显示总入网率为67.0%,形成了3个传播簇,CRF01_AE亚型形成了2个传播簇,分别包含38例、3例感染者,CRF07_BC亚型形成了1个传播簇,包含26例感染者。CRF01_AE形成的传播簇中传播关系更为复杂。2个主要的传播簇之间文化程度有显著差异。【结论】2010—2019年德宏州新报告HIV感染者MSM人群主要HIV亚型为CRF01_AE与CRF07_BC;主要的传播簇之间文化程度差异显著,应继续加强亚型监测,并对传播簇感染者实施针对性有效干预、开展专题调查。[Objective]This study aimed to investigate the HIV genotypic subtypes and molecular transmission clusters among men who have sex with men(MSM)with newly reported HIV infections in Dehong Dai and Jingpo Autonomous Prefecture(Dehong Prefecture),Yunnan Province,China,between 2010 and 2019.The study aimed to identify potential high-risk transmitters and provide reference data for screening,management,and intervention of infection sources.[Methods]Plasma samples from newly reported HIV-positive MSM individuals in Dehong Prefecture between 2010 and 2019 were collected.The viral pol gene fragments were amplified,sequenced,and genotyped.Genetic distances(GD)between pairwise sequences were analyzed and calculated.MEGA 7.0 and Gephi were used for phylogenetic and molecular transmission network analysis.[Results]A total of 159 newly reported HIV infections among MSM were included in the study,with successful genotyping of 100 cases.Nine HIV-1 subtypes were identified,with the most prevalent being CRF01_AE subtype(52%),followed by CRF07_BC subtype(31%),CRF55_01B subtype(10%),and others(7%).Cluster analysis revealed a total network access rate of 67%,forming three transmission clusters.CRF01_AE subtype formed two transmission clusters with 38 and 3 infected individuals,while CRF07_BC subtypes formed one transmission cluster with 26 infected individuals.The transmission network within the CRF01_AE clusters exhibited a more complex relationship.Significant differences in educational level were observed between the two main transmission clusters.[Conclusion]The predominant HIV subtypes among newly reported MSM cases in Dehong Prefecture between 2010 and 2019 were CRF01_AE and CRF07_BC.Significant cultural differences are observed between the main transmission clusters.Continued monitoring of genotypic subtypes and targeted interventions within transmission clusters are warranted.

关 键 词：人类免疫缺陷病毒 MSM人群 基因亚型 分子传播网络 

分 类 号：R183[医药卫生—流行病学] R512.91[医药卫生—公共卫生与预防医学]