Li Guan-Han, Chen Zhi-Wei, Chen Zheng, Wei Fei-Li, Mei Shan, Huang Yao-Xin, Zhang Lin-Qi, Cao Yun-Zhen
National Center for Sexually Transmitted Disease and Acquired Immune Deficiency Syndrome Prevention and Control, Chinese Center for Disease Control and Prevention, Beijing 100050, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2004 Dec;25(12):1013-8.
To study the distribution of human immunodeficiency virus (HIV)-1 genotypes in major prevalent regions of China and to illustrate the relationship between HIV-1 subtypes and mother-to-child transmission in a retrospective cohort.
HIV-1 gag p17 and env C2-V4 region were amplified by nested-polymerase chain reaction (nPCR) and the sequences were obtained by sequencing gag nPCR products or clones of env gene.
60 HIV-1 positive individuals were subject to typing for gag p17 and 69 for env C2-V4 region. Single clade was only found in Henan (subtype B') and Xinjiang (subtype C), and subtypes C and E were demonstrated in Yunnan. These regions represented most of the HIV-1 infections in China. Multiple subtypes (A, B, C, E, etc.) were found in Beijing and Shanghai, where HIV infections were still in low level. The sequences of subtype C were less diversive in Xinjiang (p17: 0.0192 +/- 0.0078, C2-V4: 0.0455 +/- 0.0145) than in Yunnan (p17: 0.0279 +/- 0.0102, C2-V4: 0.0482 +/- 0.0171), but all of them clustered in "C" branch in phylogenetic trees. Trafficking of subtype C from Yunnan to Xinjiang was found but had already been reported by others. Compared to subtype C, subtype E was quite divergent (p17: 0.0473 +/- 0.0105, C2-V4: 0.1114 +/- 0.0112) in Yunnan, but no recombination was found in the C2-V4 region of env gene. Highe divergence of subtype B' was found in Henan and the peripheral provinces (p17: 0.0381 +/- 0.0101, C2-V4: 0.0691 +/- 0.0166), which might be attributed to the early epidemics of HIV-1 in these areas (early 1990's). In maternal-child cohort, subtypes B (7/21), C (11/21), E (1/21) and undefined types (2/21) were identified in non-transmitting HIV-1 positive mothers, while only subtype B (7/11) and C (4/11) appeared in transmitting HIV-1 positive mothers. The rate of transmission was 53.8% (7/13) in mothers infected with subtype B and 30.8% (4/13) in those infected with subtype C, but with no significant difference (P = 0.196). The imbalancing distribution of subtypes might be explained by the fact that transfusion or illegal blood would increased mother-to-child transmission on HIV-1 and most of mothers with clade B were infected by illegal blood transfusion in this cohort. In addition, most of the maternal-child pair's sequences clustered in gag or env phylogenetic trees but only a few did disperse among the unrelated patients because children were older (>/= 4 years).
The characteristics of HIV-1 clade's distribution differed over most parts of China but no difference was demonstrated between subtype B and C in mother-to-child transmission on HIV-1.
研究中国主要流行地区人类免疫缺陷病毒1型（HIV-1）基因型的分布情况，并通过回顾性队列研究阐明HIV-1亚型与母婴传播之间的关系。
采用巢式聚合酶链反应（nPCR）扩增HIV-1 gag p17和env C2-V4区域，并通过对gag nPCR产物或env基因克隆进行测序获得序列。
60例HIV-1阳性个体进行了gag p17分型，69例进行了env C2-V4区域分型。仅在河南（B'亚型）和新疆（C亚型）发现单一进化枝，云南则存在C和E亚型。这些地区代表了中国大部分HIV-1感染情况。在北京和上海发现多种亚型（A、B、C、E等），这两个地区的HIV感染仍处于低水平。新疆C亚型序列的多样性低于云南（p17：0.0192±0.0078，C2-V4：0.0455±0.0145）（p17：0.0279±0.0102，C2-V4：0.0482±0.0171），但在系统发育树中均聚类于“C”分支。发现有C亚型从云南传播至新疆，但此前已有其他人报道过。与C亚型相比，云南的E亚型差异较大（p17：0.0473±0.0105，C2-V4：0.1114±0.0112），但在env基因的C2-V4区域未发现重组情况。在河南及其周边省份发现B'亚型差异较大（p17：0.0381±0.0101，C2-V4：0.0691±0.0166），这可能归因于这些地区HIV-1的早期流行（20世纪90年代初）。在母婴队列中，未发生HIV-1传播的阳性母亲中鉴定出B（7/21）、C（11/21）、E（1/21）和未定义类型（2/21），而发生传播的阳性母亲中仅出现B（7/11）和C（4/11）亚型。感染B亚型的母亲传播率为53.8%（7/13），感染C亚型的母亲传播率为30.8%（4/13），但差异无统计学意义（P = 0.196）。亚型分布不均衡可能是由于输血或非法采血会增加HIV-1母婴传播，且该队列中大多数B进化枝母亲是通过非法输血感染的。此外，大多数母婴对的序列在gag或env系统发育树中聚类，但只有少数分散在无关患者中，因为儿童年龄较大（≥4岁）。
中国大部分地区HIV-1进化枝的分布特征有所不同，但HIV-1母婴传播中B和C亚型之间未显示出差异。
