福建省男男同性性行为人群HIV感染状况及分子流行特征研究  

Human immunodeficiency virus infection status and molecular epidemic characteristics among men who have sex with men in Fujian province

作　　者：徐石平 陈紫桂 龚亚萍 张宏[3] 王征桦[4] 邱月锋[4] 谢美榕[4] 张春阳[4] 薛洪洪 谢剑锋[1,4] 吴守丽[1,4] XU Shiping;CHEN Zigui;GONG Yaping;ZHANG Hong;WANG Zhenghua;QIU Yuefeng;XIE Meirong;ZHANG Chunyang;XUE Honghong;XIE Jianfeng;WU Shouli(School of Public Health,Fujian Medical University,Fuzhou,Fujian 350122,China;不详)

机构地区：[1]福建医科大学公共卫生学院,福建福州350122 [2]厦门大学公共卫生学院,福建厦门361005 [3]福州市疾病预防控制中心,福建福州350005 [4]福建省疾病预防控制中心,福建省人兽共患病研究重点实验室,福建福州350012 [5]福建省性病艾滋病防治志愿者协会,福建福州350002

出　　处：《中国病毒病杂志》2024年第5期457-464,共8页Chinese Journal of Viral Diseases

基　　金：福建省卫生健康科研人才培养项目(2019-CX-9);福建省科技计划项目(2019Y0053);福建省卫生健康委员会科技计划项目(2021CXA044);福建省科技计划项目(2021Y0047)。

摘　　要：目的了解福建省男男同性性行为(men who have sex with men,MSM)人群中人类免疫缺陷病毒(human immunodeficiency virus,HIV)HIV-1感染状况,探究其影响因素及分子流行病学特征,为高危人群艾滋病精准防控提供科学依据。方法2021年10月—2023年3月通过福建省某社会组织招募MSM人群,并采集其外周血样本。采用问卷调查MSM主要人口学特征及性行为特征。通过反转录巢式聚合酶链反应(reverse transcription nested polymerase chain reaction,RT-nested PCR)特异性扩增HIV目的基因片段,使用HIV BLAST工具和系统进化树判定病毒亚型,运用美国斯坦福大学艾滋病毒耐药性数据库进行耐药分析。运用卡方检验和多因素logistic回归对MSM人群HIV感染的相关影响因素进行统计分析。结果招募的2077名MSM人群中HIV抗体阳性率为7.75%(161/2077);多因素logistic回归分析显示:年龄>60岁(OR=5.585,95%CI:1.192~26.175)、在本地居住<3个月(OR=2.120,95%CI:1.235~3.637)、最近6个月有与同性发生过肛交性行为(OR=1.849,95%CI:1.141~2.996)、梅毒快检结果阳性(OR=4.444,95%CI:2.779~7.108)是该人群HIV感染的影响因素;HIV-1基因亚型主要以CRF07_BC(50.33%)和CRF01_AE(30.46%)为主,另外检出gag,pol,env 3区亚型分析不完全一致的可疑独特重组亚型(unique recombinant forms,URFs)(19/151,12.58%);传播性耐药率为4.35%(6/138)。结论调查期间福建省MSM人群HIV抗体阳性率较往年数据有下降,传播性耐药率仍呈现低流行水平;但亚型分布情况仍然复杂,并发现传播性耐药株。应进一步加强对MSM人群的HIV-1分子流行病学特征监测,采取精准措施控制HIV-1在MSM人群中传播流行。Objective To analyze the status of HIV-1 infection among men who have sex with men(MSM)in Fujian province,explore influencing factors,analyze molecular epidemiological characteristics,and provide a scientific basis for the accurate prevention and control of AIDS in high-risk groups.Methods From October 2021 to March 2023,MSM were recruited through a local social organization in Fujian province,and peripheral blood samples were collected.The main demographic and sexual behavior characteristics were investigated by questionnaire.HIV-specific gene fragments were amplified using reverse transcription nested polymerase chain reaction(RT-nested PCR).Viral subtypes were determined by the HIV BLAST tool and phylogenetic tree.Drug resistance was analyzed by using the HIV drug resistance database of Stanford University.The Chi-square test and multiple logistic regression were used to analyze the relevant factors associated with HIV infection in the MSM population.Results The positive rate of HIV antibody in 2077 MSM patients was 7.75%(161/2077).Multivariate logistic regression analysis showed that factors influencing HIV infection included age above 60 years old(OR=5.585,95%CI:1.192-26.175),living in the local area for less than three months(OR=2.120,95%CI:1.235-3.637),engaging in anal intercourse with a male partner in the last six months(OR=1.849,95%CI:1.141-2.996),and positive syphilis rapid test results(OR=4.444,95%CI:2.779-7.108).The predominant HIV-1 subtypes were CRF07_BC(50.33%)and CRF01_AE(30.46%).In addition,the suspected unique recombinant subtypes(URFs)(19/151,12.58%)with different subtypes were detected.Prevalence of transmitted drug resistance was 4.35%(6/138).Conclusion The HIV antibody-positive rate of the MSM population in Fujian province during the observation period is lower than that in previous years,and the prevalence of transmitted drug resistance is still at a low level before treatment.However,the distribution of subtypes is still complicated,with the presence of drug-resistance strains.The molecul

关 键 词：HIV-1 男男同性性行为者 分子流行病学特征 亚型 耐药 

分 类 号：R512.91[医药卫生—内科学] R183.9[医药卫生—临床医学]