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[2016年云南省德宏傣族景颇族自治州新报告的HIV/HCV合并感染中HCV基因型的分子传播簇]

[Molecular transmission clusters on HCV genotypes among newly reported HIV/HCV co-infection in Dehong Dai and Jingpo autonomous prefecture of Yunnan province, 2016].

作者信息

Wang Y K, Chen X C, Wang J B, Duan X, Zhou S J, Yang J, Yang T, Ye R H, Yang Y C, Yao S T, Duan S, He N

机构信息

Dehong Dai and Jingpo Autonomous Prefecture Center for Disease Control and Prevention, Mangshi 678400, China.

Department of Epidemiology, School of Public Health, The Key Laboratory for Public Health Safety of Ministry of Education, Fudan University, Shanghai 200032, China.

出版信息

Zhonghua Liu Xing Bing Xue Za Zhi. 2019 Feb 10;40(2):191-195. doi: 10.3760/cma.j.issn.0254-6450.2019.02.013.

Abstract

To understand the characteristics on major strain subtypes of hepatitis C virus among HIV/HCV co-infected patients, so as to explore the molecular transmission clusters and related risk factors of HCV strains. A total of 336 newly reported HIV-infected patients were diagnosed as HIV/HCV co-infection in Dehong Dai and Jingpo autonomous prefecture (Dehong) in 2016. We used Nested PCR to amplify CE1 and NS5B genes among 318 samples with plasma levels above 200 μl, before using the combining phylogenetic tree and constructing molecular propagation network method to analyze the related data. A total of 267 HIV/HCV co-infection patients who had met the HCV genotyping requirements were screened the gene subtypes were diversified. Among these genotypes, proportions of 3b, 6n, 6u, 1a, 3a and other subtypes appeared as 32.6% (87/267), 18.4% (49/267), 15.7%(42/267), 13.1%(35/267), 11.2%(30/267) and 9.0%(24/267) respectively. Molecular transmission network of five major HCV genotypes was constructed with a clustering rate of 39.1% (95/243). The clustering rate of subtype 1a was the highest, as 71.4% (25/35). Results from the multivariate logistic regression showed that ethnic minorities other than the Yi and Jingpo (. the Han, =0.17, 95: 0.04-0.71), the married spouses (. the unmarried, =0.42, 95: 0.18-0.94), the 6n and 3a subtype (. the 3b subtype, =0.34, 95: 0.12-0.95; =0.22, 95: 0.05-0.93) were more difficult to form transmission clusters. However, the 6u and 1a subtype (. the 3b subtype, =3.10, 95: 1.21-7.94; =4.00, 95: 1.32-12.11) seemed more likely to form the transmission clusters. Ethnicity, marital status and genetic subtypes were factors significantly associated with the formation of transmission clusters related to the major HCV gene subtypes among newly reported HIV/HCV co-infection in Dehong.

摘要

为了解HIV/HCV合并感染患者中丙型肝炎病毒主要毒株亚型的特征,以探索HCV毒株的分子传播簇及相关危险因素。2016年,德宏傣族景颇族自治州(德宏)共有336例新报告的HIV感染患者被诊断为HIV/HCV合并感染。我们采用巢式PCR对318份血浆水平高于200μl的样本中的CE1和NS5B基因进行扩增,然后采用结合系统发育树和构建分子传播网络的方法对相关数据进行分析。共筛选出267例符合HCV基因分型要求的HIV/HCV合并感染患者,基因亚型呈多样化。在这些基因型中,3b、6n、6u、1a、3a等亚型的比例分别为32.6%(87/267)、18.4%(49/267)、15.7%(42/267)、13.1%(35/267)、11.2%(30/267)和9.0%(24/267)。构建了5种主要HCV基因型的分子传播网络,聚类率为39.1%(95/243)。1a亚型的聚类率最高,为71.4%(25/35)。多因素logistic回归结果显示,除彝族和景颇族以外的少数民族(汉族,比值比=0.17,95%置信区间:0.04-0.71)、已婚配偶(未婚,比值比=0.42,95%置信区间:0.18-0.94)、6n和3a亚型(3b亚型,比值比=0.34,95%置信区间:0.12-0.95;比值比=0.22,95%置信区间:0.05-0.93)较难形成传播簇。然而,6u和1a亚型(3b亚型,比值比=3.10,95%置信区间:1.21-7.94;比值比=4.00,95%置信区间:1.32-12.1)似乎更易形成传播簇。民族、婚姻状况和基因亚型是与德宏新报告的HIV/HCV合并感染中主要HCV基因亚型传播簇形成显著相关的因素。

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