青岛市MSM新发HIV-1感染者病毒基因分型及分子网络特征分析  

Genotyping and molecular network characteristics of newly reported HIV-1 infected patients among MSM in Qingdao

作　　者：马霜 尤向东[2] 张成龙 赵帅 朱晓艳[4] 张娜[4] 郝连正[4] 李亚君 王国永[4] 康殿民 Ma Shuang;You Xiangdong;Zhange Chenglong;Zhao Shuai;Zhu Xiaoyan;Zhang Na;Hao Lianzheng;Li Yajun;Wang Guoyong;Kang Dianmin(School of Public Health,Cheeloo College of Medicine,Shandong University,Jinan 250012,China;Department of Equipment and Material Management,Shandong Center for Disease Control and Prevention,Jinan 250014,China;School of Public Health and Health Administration,Shandong First Medical University(Shandong Academy of Medical Sciences),Jinan 250117,China;Department of AIDS Prevention and Control,Shandong Center for Disease Control and Prevention,Jinan 250014,China)

机构地区：[1]山东大学齐鲁医学院公共卫生学院,济南250012 [2]山东省疾病预防控制中心设备与物资管理部,济南250014 [3]山东第一医科大学(山东省医学科学院)公共卫生与健康管理学院,济南250117 [4]山东省疾病预防控制中心艾滋病防制所,济南250014

出　　处：《国际病毒学杂志》2024年第1期47-52,共6页International Journal of Virology

基　　金：山东省自然科学基金项目(ZR2022MH160);山东省医药卫生科技发展计划项目(2019WS438)。

摘　　要：目的了解青岛市男男性行为者(men who have sex with men,MSM)新发HIV-1感染者的病毒基因分型特征,构建HIV-1分子传播网络,为精准干预提供依据.方法对2022年青岛市MSM新发HIV-1感染者进行问卷调查并采集血样,提取HIV-1病毒RNA,巢式PCR扩增pol区基因片段并进行测序,确定基因分型,计算基因距离,使用MEGA v11软件、HIV-Trace等构建系统进化树与分子网络,使用SPSS 27.0进行入网影响因素分析.结果共调查158名MSM,采集152人血液样本,成功扩增135条pol区序列,共11种基因分型,主要基因分型为:CRF07_BC占42.23%(57/135),CRF01_AE占35.56%(48/135),CRF55_01B占9.63%(13/135);检出了较为特殊的复杂重组体CRF01_BC和二代重组体CRF0107.鉴定出13个传播簇,CRF07_BC形成最大的传播簇,包含43个节点,CRF01_AE包含15个节点,CRF55_01B包含11个节点.在0.03%的基因距离阈值下构建分子网络,入网率为51.11%(69/135).经χ^(2)检验与Fisher精确检验显示,HIV-1基因分型(χ^(2)=44.691,P<0.01)、是否独居(χ^(2)=4.972,P=0.026)、对艾滋病了解程度(P=0.005)进入分子网络的差异有统计学意义.检测出44条序列存在耐药突变位点,耐药突变率为32.59%(44/135),21例进入分子网络.在基因型为CRF55_01B的一个传播簇中,所有感染者均对NNRTI耐药,耐药位点均为V179E.结论青岛市MSM新发HIV-1感染者的病毒基因分型复杂多样,存在性活跃人群,尤其要把分型为CRF07_BC、非独居、对传染艾滋病抱有侥幸心理的MSM作为教育的重点,及时阻断传播链,避免分子网络的进一步扩大.Objective To understand the genotyping characteristics of newly reported HIV-1 infected patients among MSM,and to construct a molecular transmission network of HIV-1,so as to provide accurate intervention for AIDS epidemic prevention and control in Qingdao.Methods A questionnaire survey was conducted in Qingdao for newly reported HIV-1 infected patients among MSM in 2022,and blood samples were collected to extract HIV-1 virus RNA.The gene fragments in pol region were amplified by nested PCR and sequenced for determination of sub-genotype and calculation of genetic distance.Phylogenetic trees and molecular networks were constructed by MEGA v11 and HIV-Trace software.SPSS 27.0 was used to analyze the influencing factors of accessing the network.Results A total of 158 MSM were investigated,and 152 blood samples were collected.One hundred and thirty-five pol region sequences were successfully amplified.There were 11 gene subtypes.For the major subtypes,CRF07_BC accounted for 42.23%(57/135),CRF01_AE for 35.56%(48/135)and CRF55_01B as 9.63%(13/135).Special complex recombinant strain CRF01_BC and second-generation recombinant strain CRF0107 were detected.Thirteen transmission clusters were identified,and CRF07_BC formed the largest cluster with 43 nodes while CRF01_AE cluster had 15 nodes and CRF55_01B had 11 nodes.The molecular network was constructed under the gene distance threshold of 0.03%,and the network access rate was 51.11%(69/135).According to theχ^(2) test and Fisher's exact test,the differences of entering the molecular network caused by HIV-1 gene subtype(χ^(2)=44.691,P<0.01),whether living alone(χ^(2)=4.972,P=0.026)and the understanding of AIDS(P=0.005)were all statistically significant.Drug-resistant mutation sites were detected in 44 sequences,with a drug-resistant mutation rate of 32.59%(44/135)Twenty-one cases entered the molecular network.In a transmission cluster of genotype CRF55_01B,all the infected people were resistant to NNRTI,and the resistant mutations were all V179E.Conclusions The subtype

关 键 词：HIV-1感染者 MSM 基因分型 分子网络 

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