文章摘要
江河,唐凯玲,黄精华,李剑军,梁淑家,刘玄华,庞贤武,朱秋映,陈欢欢,周月姣,蓝光华.基于分子网络的广西壮族自治区HIV传播热点和跨地区传播特征分析[J].中华流行病学杂志,2022,43(9):1423-1429
基于分子网络的广西壮族自治区HIV传播热点和跨地区传播特征分析
Analysis of HIV transmission hotspots and characteristics of cross-regional transmission in Guangxi Zhuang Autonomous Region based on molecular network
收稿日期:2022-04-24  出版日期:2022-09-09
DOI:10.3760/cma.j.cn112338-20220424-00339
中文关键词: 艾滋病病毒;分子网络;传播热点;跨地区传播
英文关键词: HIV;Molecular network;Transmission hotspot;Cross-regional transmission
基金项目:国家自然科学基金(82160636);国家科技重大专项(2018ZX10715-008);广西八桂学者艾滋病防控关键技术岗位专项
作者单位E-mail
江河 广西壮族自治区疾病预防控制中心, 广西艾滋病防控与成果转化研究重点实验室, 南宁 530028  
唐凯玲 广西壮族自治区疾病预防控制中心, 广西艾滋病防控与成果转化研究重点实验室, 南宁 530028  
黄精华 广西壮族自治区疾病预防控制中心, 广西艾滋病防控与成果转化研究重点实验室, 南宁 530028  
李剑军 广西壮族自治区疾病预防控制中心, 广西艾滋病防控与成果转化研究重点实验室, 南宁 530028  
梁淑家 广西壮族自治区疾病预防控制中心, 广西艾滋病防控与成果转化研究重点实验室, 南宁 530028  
刘玄华 广西壮族自治区疾病预防控制中心, 广西艾滋病防控与成果转化研究重点实验室, 南宁 530028  
庞贤武 广西壮族自治区疾病预防控制中心, 广西艾滋病防控与成果转化研究重点实验室, 南宁 530028  
朱秋映 广西壮族自治区疾病预防控制中心, 广西艾滋病防控与成果转化研究重点实验室, 南宁 530028  
陈欢欢 广西壮族自治区疾病预防控制中心, 广西艾滋病防控与成果转化研究重点实验室, 南宁 530028  
周月姣 广西壮族自治区疾病预防控制中心, 广西艾滋病防控与成果转化研究重点实验室, 南宁 530028  
蓝光华 广西壮族自治区疾病预防控制中心, 广西艾滋病防控与成果转化研究重点实验室, 南宁 530028 lgh605@163.com 
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中文摘要:
      目的 基于分子网络分析广西壮族自治区(广西)HIV传播热点和跨地区传播特征,为优化艾滋病精准防控策略提供证据。方法 整合1997-2020年采集的5 996条广西HIV pol区序列和165 534条公开发表的非广西HIV pol区序列,使用HIV-TRACE工具以0.5%成对基因距离阈值构建分子网络。结果 进入广西HIV传播热点分子网络的序列比例为31.5%(1 886/5 996)。在HIV跨地区传播分子网络中,省内连接占51.6%(2 613/5 062),国内连接占48.0%(2 430/5 062),国际连接占0.4%(19/5 062)。与广西跨地区连接的主要地区为广东省(49.5%,1 212/2 449)、北京市(17.5%,430/2 449)、上海市(6.9%,168/2 449)、四川省(5.7%,140/2 449)、云南省(4.2%,102/2 449)、陕西省(3.8%,93/2 449)、浙江省(2.8%,69/2 449)、海南省(2.0%,49/2 449)、安徽省(1.5%,37/2 449)和江苏省(1.3%,33/2 449),其余地区与广西跨地区连接比例均<1.0%。进入广西HIV传播热点分子网络风险较高的影响因素包括≥50岁(相比于25~49岁,aOR=1.68,95%CI:1.46~1.95)、男性(相比于女性,aOR=1.21,95%CI:1.05~1.40)、未婚(相比于已婚,aOR=1.18,95%CI:1.00~1.39)、高中及以上文化程度(相比于初中及以下,aOR=1.21,95%CI:1.04~1.42)和男男性传播(相比于异性性传播,aOR=1.77,95%CI:1.48~2.12)。跨地区连接风险较高的影响因素包括男性(相比于女性:aOR=1.74,95%CI:1.13~2.75),高中及以上文化程度(相比于初中及以下,aOR=1.96,95%CI:1.43~2.69)、自由职业/待业/退休(相比于农民,aOR=1.50,95%CI:1.07~2.11)、男男性传播(相比于异性性传播,aOR=3.28,95%CI:2.30~4.72)。结论 广西存在HIV传播热点,广西与国内地区组成复杂的跨地区传播网络。后续研究应针对分子网络分析推断的高风险人群开展社会网络调查,及时识别隐匿传播链,减少HIV二代传播。
英文摘要:
      Objective To analyze HIV transmission hotspots and characteristics of cross-regional transmission in Guangxi Zhuang autonomous region (Guangxi) based on the molecular network analysis,and provide evidence for optimization of precise AIDS prevention and control strategies.Methods A total of 5 996 HIV pol sequences sampled from Guangxi between 1997 and 2020 were analyzed together with 165 534 published HIV pol sequences sampled from other regions.HIV-TRACE was used to construct molecular network in a pairwise genetic distance threshold of 0.5%.Results The proportion of HIV sequences entering the molecular network of HIV transmission hotspots in Guangxi was 31.5%(1 886/5 996).In the molecular network of HIV cross-regional transmission,the links within Guangxi accounted for 51.6%(2 613/5 062),the links between Guangxi and other provinces in China accounted for 48.0%(2 430/5 062),and the links between Guangxi and other countries accounted for 0.4%(19/5 062).The main regions which had cross-regional linked with Guangxi were Guangdong (49.5%,1 212/2 449),Beijing (17.5%,430/2 449),Shanghai (6.9%,168/2 449),Sichuan (5.7%,140/2 449),Yunnan (4.2%,102/2 449),Shaanxi (3.8%,93/2 449),Zhejiang (2.8%,69/2 449),Hainan (2.0%,49/2 449),Anhui (1.5%,37/2 449),Jiangsu (1.3%,33/2 449),and other regions (each one<1.0%),respectively.The risk factors of entering the molecular network of HIV transmission hotspots in Guangxi included being aged ≥ 50 years (compared with being aged 25-49 years,aOR=1.68,95%CI:1.46-1.95),males (compared with females,aOR=1.21,95%CI:1.05-1.40),being single (compared with being married,aOR=1.18,95%CI:1.00-1.39),having education level of high school or above (compared with having education level of junior high school or below,aOR=1.21,95%CI:1.04-1.42),acquired HIV through homosexual intercourse (compared with acquired with HIV through heterosexual intercourse,aOR=1.77,95%CI:1.48-2.12).The risk factors of cross-regional transmission included males (compared with females,aOR=1.74,95%CI:1.13-2.75),having education level of high school or above (compared with having education level of junior high school or below,aOR=1.96,95%CI:1.43-2.69),being freelancer/unemployed/retired (compared with being farmers,aOR=1.50,95%CI:1.07-2.11),acquired HIV through homosexual intercourse (compared with acquired with HIV through heterosexual intercourse,aOR=3.28,95%CI:2.30-4.72).Conclusion There are HIV transmission hotspots in Guangxi.Guangxi and other provinces in China form a complex cross-regional transmission network.Future studies should carry out social network surveys in high-risk populations inferred from the molecular network analysis for the timely identification of hidden transmission chains and reduction of the second-generation transmission of HIV.
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