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

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

Abstract

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].Chinese journal of Epidemiology,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

Received:April 24, 2022

DOI：10.3760/cma.j.cn112338-20220424-00339

KeyWord: 艾滋病病毒分子网络传播热点跨地区传播

English Key Word: HIV Molecular network Transmission hotspot Cross-regional transmission

FundProject: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

Author Name	Affiliation	E-mail
Jiang He	Guangxi Key Laboratory of AIDS Prevention and Control and Achievement Transformation, Guangxi Zhuang Autonomous Region Center for Disease Prevention and Control, Nanning 530028, China
Tang Kailing	Guangxi Key Laboratory of AIDS Prevention and Control and Achievement Transformation, Guangxi Zhuang Autonomous Region Center for Disease Prevention and Control, Nanning 530028, China
Huang Jinghua	Guangxi Key Laboratory of AIDS Prevention and Control and Achievement Transformation, Guangxi Zhuang Autonomous Region Center for Disease Prevention and Control, Nanning 530028, China
Li Jianjun	Guangxi Key Laboratory of AIDS Prevention and Control and Achievement Transformation, Guangxi Zhuang Autonomous Region Center for Disease Prevention and Control, Nanning 530028, China
Liang Shujia	Guangxi Key Laboratory of AIDS Prevention and Control and Achievement Transformation, Guangxi Zhuang Autonomous Region Center for Disease Prevention and Control, Nanning 530028, China
Liu Xuanhua	Guangxi Key Laboratory of AIDS Prevention and Control and Achievement Transformation, Guangxi Zhuang Autonomous Region Center for Disease Prevention and Control, Nanning 530028, China
Pang Xianwu	Guangxi Key Laboratory of AIDS Prevention and Control and Achievement Transformation, Guangxi Zhuang Autonomous Region Center for Disease Prevention and Control, Nanning 530028, China
Zhu Qiuying	Guangxi Key Laboratory of AIDS Prevention and Control and Achievement Transformation, Guangxi Zhuang Autonomous Region Center for Disease Prevention and Control, Nanning 530028, China
Chen Huanhuan	Guangxi Key Laboratory of AIDS Prevention and Control and Achievement Transformation, Guangxi Zhuang Autonomous Region Center for Disease Prevention and Control, Nanning 530028, China
Zhou Yuejiao	Guangxi Key Laboratory of AIDS Prevention and Control and Achievement Transformation, Guangxi Zhuang Autonomous Region Center for Disease Prevention and Control, Nanning 530028, China
Lan Guanghua	Guangxi Key Laboratory of AIDS Prevention and Control and Achievement Transformation, Guangxi Zhuang Autonomous Region Center for Disease Prevention and Control, Nanning 530028, China	lgh605@163.com

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Abstract:

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。

English Abstract:

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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