2023年湖南省新报告HIV感染者跨地区传播特征与影响因素分析  

Cross-regional transmission characteristics and influencing factors among newly HIV-infected individuals in the Hunan Province in 2023

作　　者：邹潇白[1] 胡敏 贺健梅[1] 郑军[1] 唐琪 陈曦[1] ZOU Xiaobai;HU Min;HE Jianmei;ZHENG Jun;TANG Qi;CHEN Xi(Hunan Provincial Center for Disease Control and Prevention,Changsha 410005,Hunan,China;School of Public Health,University of South China,Hengyang 421001,Hunan,China)

机构地区：[1]湖南省疾病预防控制中心,长沙410153 [2]南华大学公共卫生学院,湖南衡阳421001

出　　处：《中国艾滋病性病》2025年第3期261-266,共6页Chinese Journal of Aids & STD

基　　金：湖南省自然科学基金科卫联合项目(2023 JJ60014)。

摘　　要：目的通过构建湖南省HIV-1毒株pol基因区序列的分子网络,分析毒株在湖南省的跨地区传播特征,为HIV精准防控提供数据支持。方法采集湖南省2023年新报告539例HIV感染者血样,采用巢式PCR扩增pol区基因,利用系统进化树与在线工具鉴定亚型,HIV-TRACE构建分子传播网络,对跨地区连接影响因素进行单因素与多因素Logistic回归分析。结果共采集样本539份,获得有效序列490条。在1.5%基因距离阈值下,形成66个传播簇和179条边,入网率40.61%(199/490)。跨市分子簇21个,跨市传播节点占36.68%(73/199),跨市连接占30.17%(54/179)。最大的跨市传播簇为CRF07_BC亚型,共涉及10个市州,簇中63.89%(23/36)为MSM。以长沙为中心形成的跨地区连接边最多。多因素分析显示30岁以下(OR=3.508,95%CI:1.007~12.220),受教育程度为高中及以上(OR=3.056,95%CI:1.019~9.163)者跨地区连接风险较高。结论同性性行为感染者是湖南省HIV毒株发生跨市传播的主要人群,青年和受教育程度较高的HIV感染者发生跨市传播的风险高于其他人群。Objective This study aimed to analyze the cross-regional transmission characteristics of HIV-1 strains in the Hunan Province by constructing a molecular network based on pol gene sequences to provide valuable data for the effective prevention and control of HIV.Methods Blood samples were collected from 539 newly HIV-infected individuals in the Hunan Province in 2023.Nested polymerase chain reaction was used to amplify pol,and phylogenetic trees and online tools were used to identify the subtypes.HIV-transmission cluster engine software was used to construct a molecular transmission network,and univariate and multivariate logistic regression analyses were conducted to determine the factors affecting cross-regional transmission.Results In total,539 blood samples were collected,yielding 490 valid sequences.At 1.5%genetic distance threshold,66 molecular networks and 179 edges were formed,with a network entry rate of 40.61%(199/490).There were 21 cross-regional molecular clusters,with 36.68%(73/199)of nodes indicating intercity transmission and 30.17%(54/179)indicating cross-regional connections.The largest cross-regional transmission cluster,involving 10 municipalities,belonged to the CRF07_BC subtype,with 63.89%(23/36)of infections observed in men who have sex with men.Connections centered around Changsha constituted the major interregional edges.Multivariate analysis indicated that factors associated with high cross-regional connection risks included being under 30years of age(OR:3.508;95%CI:1.007-12.220)and having a high school education or above(OR:3.056;95%CI:1.019-9.163).Conclusions Individuals engaging in homosexual behavior were the main population responsible for the cross-regional transmission of HIV strains in the Hunan Province.Among the HIV-infected individuals,young individuals and those with high level of education exhibited a higher risk of crossregional transmission than the other populations.

关 键 词：艾滋病病毒 跨地区传播 分子网络 pol区 

分 类 号：R373.9[医药卫生—病原生物学] R512.91[医药卫生—基础医学]