柳州市1998－2012年新发现HIV基因亚型变化及HIV感染者首次CD<sub>4</sub><sup>+</sup>T淋巴细胞计数比较

曹志强; 杨文敏; 朱秋映; 蓝光华; 沈智勇; 梁淑家; 李剑军; 陈欢欢; 冯毅; 何翔; 廖玲洁; 邢辉; 阮玉华; 邵一鸣

Abstract

曹志强,杨文敏,朱秋映,蓝光华,沈智勇,梁淑家,李剑军,陈欢欢,冯毅,何翔,廖玲洁,邢辉,阮玉华,邵一鸣.柳州市1998－2012年新发现HIV基因亚型变化及HIV感染者首次CD₄⁺T淋巴细胞计数比较[J].Chinese journal of Epidemiology,2019,40(5):580-584

柳州市1998－2012年新发现HIV基因亚型变化及HIV感染者首次CD₄⁺T淋巴细胞计数比较

HIV genetic subtypes and comparison of the first CD₄⁺ T cell counts in newly diagnosed HIV infected patients in Liuzhou, 1998-2012

Received:November 14, 2018

DOI：10.3760/cma.j.issn.0254-6450.2019.05.017

KeyWord: HIV-1 基因亚型 CD₄⁺T淋巴细胞计数

English Key Word: HIV-1 Genetic subtypes CD₄⁺T cell counts

FundProject:广西医药卫生自筹经费计划课题（Z20170126）；广西壮族自治区科学技术厅（桂科AB16380213）；国家自然科学基金（81460510，81360442）；广西八桂学者艾滋病防控关键技术岗位专项

Author Name	Affiliation	E-mail
Cao Zhiqiang	National Center for ADIS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
Yang Wenmin	Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530028, China
Zhu Qiuying	Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530028, China
Lan Guanghua	Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530028, China
Shen Zhiyong	Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530028, China
Liang Shujia	Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530028, China
Li Jianjun	Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530028, China
Chen Huanhuan	Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention, Nanning 530028, China
Feng Yi	National Center for ADIS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
He Xiang	Guangdong Provincial Institute of Public Health, Guangzhou 511430, China
Liao Lingjie	National Center for ADIS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
Xing Hui	National Center for ADIS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China
Ruan Yuhua	National Center for ADIS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China	ruanyuhua92@163.com
Shao Yiming	Peking University Health Science Center, Beijing 100191, China	yshao@bjmu.edu.cn

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Abstract:

目的分析柳州市1998－2012年新发现HIV基因亚型变化，比较HIV感染者首次CD₄⁺T淋巴细胞计数（CD₄），为艾滋病防治提供参考依据。方法选取我国艾滋病综合防治信息系统中1998－2012年柳州市新发现HIV感染者，对其血浆进行RNA提取、扩增、测序和分型。采用Coharan-Armitage趋势检验法分析HIV基因亚型变化的趋势，采用Wilcoxon秩和检验法分析比较HIV感染者的首次CD₄。结果研究对象共有1 877例HIV感染者。1998－2012年，CRF01_AE、CRF01_AE（Cluster 1）和CRF07_BC亚型构成比分别从78.4%（76/97）上升至91.5%（1 441/1 574）、63.9%（62/97）上升至74.0%（1 164/1 574）和17.5%（17/97）下降至4.6%（72/1 574），趋势性检验差异均有统计学意义（Z=4.632，P<0.001；Z=2.455，P=0.014；Z=-5.943，P<0.001）。CRF01_AE（Cluster 1）、CRF01_AE（Cluster 2）、CRF07_BC和CRF08_BC亚型HIV感染者首次CD₄的中位数及四分位数间距分别是230（83～375）、215（48～351）、365（254～503）和334（206～479）个/μl。CRF01_AE（Cluster 1）和CRF01_AE（Cluster 2）亚型HIV感染者的首次CD₄均Z=-4.795，P<0.001；Z=-4.238，P<0.001）。结论 1998－2012年柳州市新发现HIV感染者以CRF01_AE亚型为主并呈上升趋势，其首次CD₄较低，且新发现CRF01_AE亚簇的种类在增加，其亚簇构成比存在变化趋势。

English Abstract:

Objective To analyze the change trend of HIV genetic subtypes and compare the first CD₄⁺T cell counts of newly diagnosed HIV infected patients in Liuzhou from 1998 to 2012, and provide a reference for AIDS prevention and control. Methods Newly diagnosed HIV-infected patients from 1998 to 2012 in Liuzhou were selected through national HIV/ADIS comprehensive response information management system. Their plasma samples were used for RNA gene extraction, amplification, sequencing and genotyping. Coharan-Armitage trend test was used to analyze the ratio trend of genetic subtypes and phylogenetic clusters of HIV and Wilcoxon Rank Sum Test was used to compare the first CD₄⁺T cell counts (CD₄) of the different subtype HIV infected patients. Results A total of 1 877 newly diagnosed HIV infected patients were included in the study. From 1998 to 2012, the proportions of CRF01_AE and CRF01_AE (Cluster 1) increased from 78.4% (76/97) to 91.5% (1 441/1 574), from 63.9% (62/97) to 74.0% (1 164/1 574), and the proportion of CRF07_BC decreased from 17.5% (17/97) to 4.6% (72/1 574), respectively (Z=4.632, P<0.001; Z=2.455, P=0.014; Z=-5.943, P<0.001). The median and interquartile range of the first CD₄ of the patients infected with subtype CRF01_AE (Cluster 1), CRF01_AE (Cluster 2), CRF07_BC and CRF08_BC were 230 (83-375), 215 (48-351), 365 (254-503) and 334 (206-479) cell/μl, respectively. The first CD₄ levels of the patients infected with subtype CRF01_AE (Cluster 1) or CRF01_AE (Cluster 2) were significantly lower than those of CRF07_BC (Z=-4.795, P<0.001; Z=-4.238, P<0.001). Conclusion The genetic subtypes of HIV were mainly CRF01_AE in newly diagnosed HIV-infected patients and this subtype proportion was in increase and the first CD₄ levels of the patients were low in Liuzhou during 1998 to 2012.

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