2020-2022年浙江省金华市新报告50岁及以上经异性性传播HIV/AIDS患者分子网络特征分析  

Molecular network characteristics analysis on heterosexual transmission of HIV/AIDS in people aged≥50 years in Jinhua,Zhejiang,2020−2022

作　　者：王凤英[1] 唐慧玲[1] 蒋均[2] 方琼楼[1] 朱珂 范钦[2] 金屡华 吴斌[1] Wang Fengying;Tang Huiling;Jiang Jun;Fang Qionglou;Zhu Ke;Fan Qin;Jin Lyuhua;Wu Bin(Jinhua Prefectural Center for Disease Control and Prevention,Jinhua 321002,Zhejiang,China;Zhejiang Provincial Center for Disease Control and Prevention,Hangzhou 310051,Zhejiang,China)

机构地区：[1]金华市疾病预防控制中心,浙江金华321002 [2]浙江省疾病预防控制中心,浙江杭州310051

出　　处：《疾病监测》2024年第8期1001-1007,共7页Disease Surveillance

基　　金：金华市科技计划(No.2022-4-221,No.2022-4-222)。

摘　　要：目的 分析浙江省金华市2020-2022年新报告经异性性传播≥50岁人类免疫缺陷病毒/获得性免疫缺陷综合征(HIV/AIDS)病例性行为和传播网络特点,为艾滋病精准防控提供依据。方法 对2020-2022年新报告的经异性性传播≥50岁HIV/AIDS病例开展流行病学调查,采集调查对象抗病毒治疗前的血液样本,通过核酸提取、聚合酶链式反应(PCR)扩增pol基因,通过Sequencher 5.0软件拼接整理测序结果,BioEdit v7.2.0软件进行序列比对,MEGA 6.0软件构建系统进化树,使用Cytoscape 3.6.0软件构建HIV分子传播网络进行分析。结果 517例经异性性传播病例中,以1年前感染(369例,71.37%)、本地感染(309例,59.77%)为主;经商业异性性行为传播242例(46.81%),经非婚非商业异性性行为传播213例(41.20%),经配偶固定性伴传播62例(11.99%)。采集血样410份,成功获得序列369条,共检出14种HIV-1基因亚型,以CRF07_BC(179例,48.51%)、CRF01_AE(98例,26.56%)、CRF08_BC(58例,15.72%)为主。165条序列进入分子传播网络,形成40个簇。影响因素分析结果显示,60岁及以上年龄组[与50~59岁年龄组比较,比值比(OR)=1.70,95%置信区间(CI):1.04~2.79]、阳性者配偶或性伴检测(与临床就诊比较,OR=3.68,95%CI:1.32~10.22)的HIV-1成簇率更高,高中及以上文化程度(与小学及不识字/少识字比较,OR=0.41,95%CI:0.18~0.90)的HIV-1成簇率更低。8个大簇占成簇病例数的49.09%(81/165),C1、C2传播以包含暗娼病例的商业异性性行为为主;C3、C5、C6和C8以未含暗娼的商业异性性行为为主;C4以某男性病例为核心通过非婚非商业异性性行为感染HIV,继而引起婚内和固定性伴间的传播;C7以另一男性病例为核心通过商业异性性行为感染HIV,继而引起4名非婚非商业异性性伴感染。结论 浙江省金华市经异性性传播≥50岁中老年病例商业异性性行为和非婚非商业异性性行为并存,HIV-1亚型多样,成大簇的本地感染比例较高,区�Objective To analyze the characteristics of sexual behaviors and transmission network of newly confirmed human immunodeficiency virus(HIV)/acquired immuno deficiency syndrome(AIDS)cases caused by heterosexual transmission in people aged≥50 years in Jinhua,Zhejiang province,from 2020 to 2022,and provide evidence for the precise prevention and control of AIDS.Methods An epidemiological survey was conducted in newly confirmed HIV/AIDS cases caused by heterosexual transmission in people aged≥50 years in Jinhua from 2020 to 2022.Meanwhile,blood samples from the newly diagnosed HIV infection cases before antiviral treatment were collected.Pol gene was amplified by nucleic acid extraction and PCR,sequenced with software Sequencer 5.0,and phylogenetic tree was constructed by using software MEGA 6.0,and software Cytoscape 3.6.0 was used to establish HIV molecular transmission network.Results In the 517 HIV/AIDS cases caused by heterosexual transmission in Jinhua,369 were infected more than 1 year ago(71.37%),309 were local infections(59.77%),and 242 were infected through commercial heterosexual behaviors(46.81%),213 were infected through non-marital and non-commercial heterosexual behaviors(41.20%),and 62 were transmitted by their spouses(11.99%).A total of 410 blood samples were collected,and 369 sequences were successfully obtained.A total of 14 subtypes of HIV-1 gene were detected,with CRF07-BC(179 cases,48.51%),CRF01-AE(98 cases,26.56%),CRF08-BC(58 cases,15.72%)as the main subtypes,and 165 sequences were used in the molecular network,forming 40 clusters.The results of multivariate analysis showed that the HIV-1 clustering rate was higher in age group≥60 years compared with age group of 50-59 years(OR=1.70,95%CI:1.04−2.79),and in the testing of spouses or sexual partners of positive individuals compared with clinical detection(OR=3.68,95%CI:1.32−10.22).The HIV-1 clustering rate was lower in those with education level at or above senior high school compared with those with education level of primary school or

关 键 词：中老年人 人类免疫缺陷病毒 分子传播网络 异性性传播 

分 类 号：R211[医药卫生—中医学] R512.9