中国安徽省 HIV-1 流行的遗传特征。
Genetic characterization of HIV-1 epidemic in Anhui Province, China.
机构信息
Department of AIDS Research, State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, 20 Dongda Street, Fengtai District, Beijing, 100071, China.
Anhui Provincial Center for Disease Control and Prevention, Hefei, 230601, China.
出版信息
Virol J. 2020 Feb 3;17(1):17. doi: 10.1186/s12985-020-1281-y.
BACKGROUND
Anhui Province in China is facing a severe HIV epidemic with an increasing number of newly diagnosed cases.
METHODS
In this study, HIV genetic characteristics in the province were investigated. Newly reported HIV-positive individuals from 15 districts of Anhui Province were enrolled and interviewed. Total viral RNA was extracted from plasma isolated from blood samples. We amplified and sequenced an HIV pol fragment of the 1062 bp. The sequences were used for determination of HIV subtypes and the presence of drug resistance mutations. Transmission networks were constructed to explore possible relationships. And all of assembled partial pol genes were submitted to the Stanford HIV Drug Resistance Database website to find the transmitted drug resistance.
RESULTS
Partial pol gene sequences were obtained from 486 cases. The results showed that MSM was the most dominant transmission route (253, 52.06%), followed by heterosexual transmission (210, 43.21%) and blood-borne transmission (1, 0.21%). Many subtypes were identified, including CRF01_AE (226, 46.50%), CRF07_BC (151, 31.07%), subtype B (28, 5.76%), CRF08_BC (20, 4.12%), CRF55_01B (15, 3.09%), CRF68_01B (7, 1.44%), CRF67_01B (3, 0.62%), CRF57_BC (2, 0.41%), CRF59_01B (2, 0.41%), CRF79_0107 (2, 0.41%), subtype C (2, 0.41%), CRF64_BC (1, 0.21%), and circulating recombinant forms (URFs) (27, 5.55%). Four transmission subnetworks containing high transmission risk individuals (with degree ≥4) were identified based on CRF01_AE and CRF07_BC sequences, including two CRF01_AE transmission subnetworks constituted by elderly people with average ages of 67.9 and 61.5 years. Infection occurred most likely through heterosexual transmission, while the other two CRF07_BC transmission subnetworks consist mainly of MSMs with average ages of 31.73 and 34.15. The level of HIV-transmitted drug resistance is 3.09%.
CONCLUSIONS
The simultaneous spread of multiple HIV subtypes in Anhui province underscores that close surveillance of the local HIV epidemic is necessary. Furthermore, the elderly people were frequently involved, arguing for behaviour intervention in this specific population besides the MSM risk group.
背景
中国安徽省正面临着严峻的 HIV 疫情，新诊断病例数量不断增加。
方法
本研究旨在调查该省的 HIV 遗传特征。我们招募并采访了来自安徽省 15 个区的新报告的 HIV 阳性个体。从血液样本中分离的血浆中提取总病毒 RNA。我们扩增并测序了长度为 1062bp 的 HIV pol 片段。使用该序列确定 HIV 亚型和耐药突变的存在。构建传播网络以探索可能的关系。将所有组装的部分 pol 基因提交给斯坦福 HIV 耐药性数据库网站，以发现传播的耐药性。
结果
从 486 例中获得了部分 pol 基因序列。结果表明，MSM 是最主要的传播途径（253 例，52.06%），其次是异性传播（210 例，43.21%）和血液传播（1 例，0.21%）。鉴定出多种亚型，包括 CRF01_AE（226 例，46.50%）、CRF07_BC（151 例，31.07%）、B 亚型（28 例，5.76%）、CRF08_BC（20 例，4.12%）、CRF55_01B（15 例，3.09%）、CRF68_01B（7 例，1.44%）、CRF67_01B（3 例，0.62%）、CRF57_BC（2 例，0.41%）、CRF59_01B（2 例，0.41%）、CRF79_0107（2 例，0.41%）、C 亚型（2 例，0.41%）、CRF64_BC（1 例，0.21%）和循环重组形式（URFs）（27 例，5.55%）。根据 CRF01_AE 和 CRF07_BC 序列，确定了四个包含高传播风险个体（度数≥4）的传播子网络，包括两个由平均年龄为 67.9 和 61.5 岁的老年人构成的 CRF01_AE 传播子网。感染最有可能通过异性传播发生，而另外两个 CRF07_BC 传播子网主要由平均年龄为 31.73 和 34.15 的 MSM 组成。HIV 传播耐药水平为 3.09%。
结论
安徽省同时传播多种 HIV 亚型，这表明有必要密切监测当地 HIV 疫情。此外，老年人经常参与其中，除了 MSM 风险群体外，还需要对这一特定人群进行行为干预。
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