广州市2008-2015年男男性行为人群HIV-1亚型分布特征及变化趋势

韩志刚; 张亚丽; 吴昊; 程伟彬; 梁彩云; 钟斐; 高凯; 徐慧芳

Abstract

韩志刚,张亚丽,吴昊,程伟彬,梁彩云,钟斐,高凯,徐慧芳.广州市2008-2015年男男性行为人群HIV-1亚型分布特征及变化趋势[J].Chinese journal of Epidemiology,2018,39(1):67-71

广州市2008-2015年男男性行为人群HIV-1亚型分布特征及变化趋势

Characteristic and dynamic of HIV-1 subtype distribution in men who have sex with men in Guangzhou, 2008-2015

Received:June 28, 2017

DOI：10.3760/cma.j.issn.0254-6450.2018.01.014

KeyWord: 艾滋病病毒,1型男男性行为者亚型

English Key Word: HIV-1 Men have sex with men Subtype

FundProject:广州市科技计划项目（201707010184，201704020219）；广州市医药卫生科技项目（20161A011054）

Author Name	Affiliation	E-mail
Han Zhigang	Department of Operational Control, Guangzhou Center for Disease Control and Prevention, Guangzhou 510440, China	zhiganghan616@163.com
Zhang Yali	School of Public Health, Guangdong Pharmaceutical University, Guangzhou 510310, China
Wu Hao	Department of AIDS Control and Prevention, Guangzhou Center for Disease Control and Prevention, Guangzhou 510440, China
Cheng Weibin	Department of AIDS Control and Prevention, Guangzhou Center for Disease Control and Prevention, Guangzhou 510440, China
Liang Caiyun	Department of AIDS Control and Prevention, Guangzhou Center for Disease Control and Prevention, Guangzhou 510440, China
Zhong Fei	Department of AIDS Control and Prevention, Guangzhou Center for Disease Control and Prevention, Guangzhou 510440, China
Gao Kai	Department of AIDS Control and Prevention, Guangzhou Center for Disease Control and Prevention, Guangzhou 510440, China
Xu Huifang	Department of AIDS Control and Prevention, Guangzhou Center for Disease Control and Prevention, Guangzhou 510440, China

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Abstract:

目的了解2008－2015年广州市MSM人群HIV-1感染者（MSM感染者）HIV-1亚型分布特征及变化趋势。方法研究对象为2008－2015年确证的HIV-1感染者、男男性行为途径感染、现住址为广州市。收集血清样本提取HIV-1 RNA，采用巢式 PCR法扩增HIV-1 pol区基因片段，测序后构建系统进化树，确定HIV-1亚型，比较不同年份和不同特征样本的HIV-1亚型分布。结果从2 473份血清样本中成功获得2 210份样本的pol区基因片段。2 210份样本人群的年龄（30.19±8.22）岁；未婚者占73.39%；汉族占90.81%。独特重组形式（URFs）亚型在职业为农民及农民工的构成比高于其他职业者（P＝0.017，99%CI：0.014～0.020），URFs亚型在多性伴者的构成比高于非多性伴者（ χ²＝5.733，P＝0.017）。HIV-1亚型分布以CRF07_BC（38.10%）和CRF01_AE（34.84%）为主，其次为CRF55_01B（14.62%）、B（6.06%）、URFs（3.58%）、CRF59_01B（2.17%）和其他亚型（0.63%）。B、CRF07_BC、CRF55_01B和URFs亚型在2008－2015年的各年份构成比的差异有统计学意义（B：P＝0.000，99%CI：0.000～0.000；CRF07_BC：χ²＝14.965，P＝0.036；CRF55_01B：χ²＝18.161，P＝0.011；URFs：P＝0.001，99%CI：0.000～0.001），其中B亚型的构成比呈逐年下降趋势（P＝0.000，99%CI：0.000～0.000），URFs亚型的构成比呈逐年上升趋势（P＝0.000，99%CI：0.000～0.000）。结论 2008－2015年广州市MSM感染者HIV-1亚型分布表现为CRF07_BC和CRF01_AE为主、多个亚型共存的特点。URFs亚型的构成比呈上升趋势提示HIV-1在MSM感染者中在不断发生重组。应针对MSM感染者农民及农民工、多性伴者加强干预。

English Abstract:

Objective To understand the characteristics and dynamic of HIV-1 subtype distribution in men who have sex with men (MSM) in Guangzhou between 2008 and 2015. Methods HIV-1 RNAs were extracted from serum samples of the individuals newly diagnosed with HIV-1 infection among MSM living in Guangzhou between 2008 and 2015. The pol gene segments of HIV-1 genome from these RNA samples were amplified by nested reverse transcription polymerase chain reaction (nested-PCR) and were sequenced. Subsequently, the phylogenetic tree was reconstructed using pol sequences of samples and references together and the subtype of HIV-1 was determined. The distributions of HIV-1 subtypes detected in MSM with different demographic characteristics in different years were compared. Results A total of 2 210 pol gene segments were successfully obtained from 2 473 serum samples of the MSM. The average age of 2 210 MSM was 30.19 years with standard deviation of 8.22 years, the unmarried MSM and those in Han ethnic group accounted for 73.39% and 90.81%, respectively. The proportion of subtype CRF07_BC (38.10%) was highest, followed by CRF01_AE (34.84%), CRF55_01B (14.62%), B (6.06%), URFs (3.58%), CRF59_01B (2.17%) and other subtypes (0.63%). The annual proportions of subtype B (P=0.000, 99%CI:0.000-0.000), CRF07_BC (χ²=14.965, P=0.036), CRF55_01B (χ²=18.161, P=0.011) and URFs (P=0.001, 99%CI:0.000-0.001) were significantly different. The proportion of subtype B showed a gradual decrease from 14.08% to 4.33% (P=0.000, 99%CI:0.000-0.000), while the proportion of URFs rapidly increased from 0% to 6.40% (P=0.000, 99%CI:0.000-0.000). The rate of URFs was significantly higher in farmers and migrant workers than in other groups (P=0.017, 99%CI:0.014-0.020) and the rate of URFs was higher in individuals who had multi sexual partners (χ²=5.733, P=0.017). Conclusions CRF07_BC and CRF01_AE were the predominant HIV-1 subtypes and multiple subtypes co-circulated among MSM in Guangzhou between 2008 and 2015. The recombinations of HIV-1 continue to occur in MSM. Strengthening behavioral intervention for farmers, migrant workers and individuals who have multi sexual partners has the important epidemiological significance against the emerging and circulating of the novel recombinant virus among MSM in Guangzhou.

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