Anhui Provincial Center for Disease Control and Prevention, Hefei, 230601, China.
Department of AIDS Research, State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, 100071, China.
BMC Infect Dis. 2019 Jun 27;19(1):562. doi: 10.1186/s12879-019-4187-9.
The proportion of older HIV-1 infected people in China has increased rapidly in recent years. Elucidation of the transmission characteristics of this high-risk population subgroup is helpful for the development of tailored interventions.
A phylogenetic analysis was performed that uses available HIV-1 pol sequences amplified with nested RT-PCR from plasma samples of all newly diagnosed participants spanning from October 2017 to September 2018 in Fuyang, Anhui Province. Transmission clusters were identified as two or more sequences that shared a corresponding node with an aLRT-SH value ≥90 in the maximum-likelihood phylogenetic tree and had an overall mean genetic distance of ≤1.5%. A local transmission cluster was defined as a cluster that had more than 80% of its sequences from Fuyang. The role of older people in local HIV-1 transmission was determined using an integration of molecular and demographic data.
Of 362 available sequences, 14 subtypes, and 28 local transmission clusters were identified. It was found that the proportion of older people in the local transmission cluster (69/77, 89.61%) was much higher than that of younger people (46/114, 40.35%) (χ test, P < 0.001). In the pretreatment drug resistance analysis, the proportion of sequences with PDRMs in the local transmission cluster was not significantly different between the older people group (57.14%, 4/7) and non-old-aged group (11.11%, 1/9) (Fisher's exact test, P > 0.05).
By combining phylogenetic analyses with demographic data, more detailed information was provided about the local transmission structure in Fuyang. These findings suggested that older people play an important role in local transmission, and more tailored interventions for this population subgroup are urgently needed.
近年来，中国感染 HIV-1 的老年人比例迅速增加。阐明这一高危人群亚组的传播特征有助于制定针对性干预措施。
对 2017 年 10 月至 2018 年 9 月期间在安徽省阜阳市新诊断的所有参与者的血浆样本进行了巢式 RT-PCR 扩增的 HIV-1 pol 序列进行了系统发育分析。将具有相应节点的两个或更多序列定义为具有相同的 aLRT-SH 值≥90 的最大似然系统发育树和总体平均遗传距离≤1.5%的传播簇。将一个本地传播簇定义为一个簇，其 80%以上的序列来自阜阳。利用分子和人口统计数据的整合来确定老年人在本地 HIV-1 传播中的作用。
在 362 个可用序列中，确定了 14 种亚型和 28 个本地传播簇。结果发现，本地传播簇中老年人的比例（69/77，89.61%）明显高于年轻人（46/114，40.35%）（卡方检验，P<0.001）。在预处理耐药性分析中，本地传播簇中具有 PDRMs 的序列比例在老年人组（57.14%，4/7）和非老年组（11.11%，1/9）之间无显著差异（Fisher 确切检验，P>0.05）。
通过将系统发育分析与人口统计数据相结合，提供了关于阜阳市本地传播结构的更详细信息。这些发现表明，老年人在本地传播中起着重要作用，迫切需要针对这一人群亚组制定更具针对性的干预措施。
