2019-2022年深圳市HIV-1人群的多区段亚型分布特征  

Epidemiological characteristics of multi-compartmental subtypes among the HIV-1 population in Shenzhen,2019-2022

作　　者：袁小洪 杨梓杰 郑陈丽[2] 唐虎 李浩[2] 张燕[2] 谭唯[2] 黎桂连[2] 甘永霞[2] 钟一帆 王晓辉[2] 刘少础[2] 谢炜[2] 卫兰 赵锦 YUAN Xiaohong;YANG Zijie;ZHENG Chenli;TANG Hu;LI Hao;ZHANG Yan;TAN Wei;LI Guilian;GAN Yongxia;ZHONG Yifan;WANG Xiaohui;LIU Shaochu;XIE Wei;WEI Lan;ZHAO Jin(School of Public Health,Southern Medical University,Guangzhou 510515,Guangdong,China;Shenzhen Center for Disease Control and Prevention,Shenzhen 518000,Guangdong,China;Peking University,Beijing 100083,China;School of Public Health,Shanxi Medical University,Taiyuan 030607,Shanxi,China)

机构地区：[1]南方医科大学公共卫生学院,广州510515 [2]深圳市疾病预防控制中心,广东深圳518000 [3]北京大学公共卫生学院,北京100083 [4]山西医科大学公共卫生学院,太原030607

出　　处：《中国艾滋病性病》2025年第2期127-133,共7页Chinese Journal of Aids & STD

基　　金：国家自然科学基金(82373651);深圳市医学重点学科建设经费(SZXK064);深圳市医疗卫生三名工程(SZSM202311015)。

摘　　要：目的 通过多区段序列亚型鉴定,分析深圳市新报告HIV的亚型流行分布和人群特征。方法 以2019-2022年深圳市疾病预防控制中心收集的HIV新报告病例作为研究对象。通过分析pol区和gag区的亚型并结合感染信息,描述pol区、gag区和pol+gag区的亚型鉴定结果,采用多分类Logistic回归方法分析不同HIV亚型的流行特征。结果 深圳市2019-2022年3 198名HIV新报告病例成功测得pol区和gag区序列,其中2 768人(86.6%,2768/3198)两区段序列亚型鉴别一致。3 198例新报告病例的平均年龄为(35.33±0.42)岁,感染途径以同性性传播为主(65.0%,2079/3198)。只使用pol区鉴定出的亚型不确定占2.3%(72例)。只使用gag区鉴定出的亚型不确定占1.3%(43例)。通过pol+gag区鉴定的HIV-1亚型分布为CRF07_BC(46.0%,1471例)、CRF01_AE(24.0%,767例)、CRF55_01B(9.9%,316例)、其他(6.7%,214例)和亚型不一致(13.5%,430例)。对2 768例亚型一致的病例进行多分类Logistic回归分析显示,与亚型为CRF07_BC的感染者相比,CRF01_AE人群更可能年龄大于50岁(aOR=1.524,95%CI:1.087~2.136)、女性(aOR=1.899,95%CI:1.359~2.654)和通过异性性传播感染(aOR=1.486,95%CI:1.191~1.854);而CRF55_01B人群更可能为男性(aOR=4.587,95%CI:1.629~12.987)和未婚(aOR=1.621,95%CI:1.086~2.421)。结论 多区段序列分析发现人群独特重组型流行率高于仅用pol区或gag区鉴定分析结果。深圳市存在一定比例尚未鉴别的HIV-1多重感染、衍生重组或新型重组毒株。应推进对深圳市MSM和中老年人群的HIV筛查,加强对该人群的HIV风险干预。Objective This study aimed to analyze the subtype distribution and population characteristics of newly reported HIV cases in Shenzhen by identifying multi-compartmental sequences.Methods Newly reported HIV cases recorded by the Shenzhen Center for Disease Control and Prevention from 2019 to 2022 were investigated in the study.By analyzing the subtypes of the pol and gag regions and combining them with infection information,the results of subtype identification for the pol,gag,and pol+gag regions are described.Multiclass logistic regression was used to analyze the epidemiological characteristics of the different HIV subtypes.Results The pol and gag regions were successfully sequenced in 3198 newly reported HIV cases from 2019 to 2022 in Shenzhen,with 2768 individuals(86.6%,2768/3198)showing consistent subtype identification in both regions.The average age of the 3198 newly reported cases was 35.33±0.42 years,and the primary mode of transmission was homosexual contact(65.0%,2079/3198).Uncertain subtypes identified using only the pol region accounted for 2.3%(72 cases).Uncertain subtypes identified using only the gag region accounted for 1.3% (n=43). The HIV-1 subtypes identified by pol+gagregions were CRF07_BC (46.0%, 1471 cases), CRF01_AE (24.0%, 767 cases), CRF55_01B (9.9%, 316 cases), others(6.7%, 214 cases), and inconsistent subtypes (13.5%, 430 cases). Multivariate logistic regression analysis of 2 768 caseswith consistent subtypes showed that compared to individuals infected with the CRF07_BC subtype, those with theCRF01_AE subtype were more likely to be over 50 years old [adjusted odds ratio (aOR)=1.524, 95% confidence intervalCI: 1.087-2.136], female (aOR=1.899, 95%CI: 1.359-2.654), and infected through heterosexual transmission (aOR=1.486,95%CI: 1.191-1.854);whereas those with the CRF55_01B subtype were more likely to be male (aOR=4.587, 95%CI:1.629-12.987) and unmarried (aOR=1.621, 95%CI: 1.086-2.421). Conclusions Multi-compartmental sequence analysisrevealed that the prevalence of unique recombinant for

关 键 词：艾滋病病毒 亚型 男男性行为者 多区段序列分析 

分 类 号：R512.91[医药卫生—内科学] R373.9[医药卫生—临床医学]