云南省德宏州2015—2016年新报告HIV感染者主要亚型毒株的传播特征
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摘要
目的探讨云南省德宏州2015—2016年新报告艾滋病病毒(HIV)感染者主要亚型毒株的传播特征。方法对新报告HIV感染者进行血浆HIV病毒载量检测、扩增pol基因和测序,构建系统进化树、提取传播簇、选择最小基因距离构建HIV传播网络。结果中国籍与缅甸籍HIV感染者在年龄、婚姻、民族、文化程度、传播方式、基因亚型上的分布差异均有统计学意义(P<0.05)。227条CRF01_AE亚型pol区序列形成的传播网络中,其成簇率为33.0%(75/227);而在90条B亚型pol区序列和368条C亚型pol区序列形成的网络中,成簇率分别为54.4%(49/90)、70.7%(260/368)。感染CRF01_AE亚型毒株的人群中,男性成簇>10条序列为7.7%,女性为1.2%;缅甸籍为6.5%,中国籍为3.4%。感染C亚型毒株的人群中,>40岁成簇>10条序列的为29.1%,≤40岁为15.5%;中国籍为26.8%,缅甸籍为14.2%。此外研究发现,有患者的CRF01_AE亚型形成的传播网络"度"高达120,为超级传播者。结论在感染CRF01_AE亚型毒株的人群中,男性与缅甸籍更易形成大簇;在感染C亚型毒株的人群中,年龄>40岁、中国籍更易形成大簇。超级传播者在HIV感染者不同毒株的分子传播网络形成中都起到重要作用。
Objective To explore the evolutionary dynamics and molecular transmission patterns of HIV-1 CRF01_AE,B,C in depth among 2015-2016 newly reported HIV infections in Dehong prefecture of Yunnan province.MethodsWe detected the viral load,amplified the pol gene and sequenced to construct the propagation network by building the phy-logenetic tree,extracting the transmission cluster and selecting the minimum gene distance.Results There were significantdifferences in the distribution of age,marriage,ethnicity,education level,transmission route and gene subtype betweenChinese and Burmese HIV-infected patients(P<0.05).Of 227 CRF01_AE sequences,its clustering rate was 33.0%(75/227).Of 90 Bsequences the clustering rate was 54.4%(49/90).Of 368 Csequences,the clustering rate was 70.7%(260/368).Compared with those in other parts of China,there was a large proportion of super-communicators in Dehongprefecture.Among the male and female infected persons of the CRF01_AE subtype stain,>10 sequences in the cluster ac-counted for 7.7% and 1.2%,respectively;meanwhile,Chinese and Burmese accounted for 3.4% and 6.5%,respectively.Among the infected people of>40 years oldand≤40 years old infected with subtype C strains,>10 sequences in the cluster accounted for 29.1%and 15.5%,respectively;and Chinese and Burmese accounted for26.8% and 14.2%,respectively.In addition,the studyfound that the patients with CRF01_AE subtype formed anetwork of "degree" of up to 120,called super-spreader.Conclusion Among the people infected with CRF01_AEsubtype strains,males and Burmese are more likely to form larger clusters.Among those infected with subtype C strains,those aged>40 years and Chinese are more likely to form larger clusters.Super-spreaders play an important role in the for-mation of molecular transmission networks of different strains of HIV-infected individuals.
Objective To explore the evolutionary dynamics and molecular transmission patterns of HIV-1 CRF01_AE,B,C in depth among 2015-2016 newly reported HIV infections in Dehong prefecture of Yunnan province.MethodsWe detected the viral load,amplified the pol gene and sequenced to construct the propagation network by building the phy-logenetic tree,extracting the transmission cluster and selecting the minimum gene distance.Results There were significantdifferences in the distribution of age,marriage,ethnicity,education level,transmission route and gene subtype betweenChinese and Burmese HIV-infected patients(P<0.05).Of 227 CRF01_AE sequences,its clustering rate was 33.0%(75/227).Of 90 Bsequences the clustering rate was 54.4%(49/90).Of 368 Csequences,the clustering rate was 70.7%(260/368).Compared with those in other parts of China,there was a large proportion of super-communicators in Dehongprefecture.Among the male and female infected persons of the CRF01_AE subtype stain,>10 sequences in the cluster ac-counted for 7.7% and 1.2%,respectively;meanwhile,Chinese and Burmese accounted for 3.4% and 6.5%,respectively.Among the infected people of>40 years oldand≤40 years old infected with subtype C strains,>10 sequences in the cluster accounted for 29.1%and 15.5%,respectively;and Chinese and Burmese accounted for26.8% and 14.2%,respectively.In addition,the studyfound that the patients with CRF01_AE subtype formed anetwork of "degree" of up to 120,called super-spreader.Conclusion Among the people infected with CRF01_AEsubtype strains,males and Burmese are more likely to form larger clusters.Among those infected with subtype C strains,those aged>40 years and Chinese are more likely to form larger clusters.Super-spreaders play an important role in the for-mation of molecular transmission networks of different strains of HIV-infected individuals.
引文
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[7]Yuan R,Cheng H,Chen LS,et al.Prevalence of different HIV-1subtypes in sexual transmission in China:a systematic review and meta-analysis[J].Epidemiology&Infection,2016,144(10):2144.
[8]Kusagawa S,Sato H,Watanabe S,et al.Genetic and serologic characterization of HIV type 1prevailing in Myanmar(Burma)[J].AIDS Research&Human Retroviruses,1998,14(15):1379.
[9]姚志红,郑永唐.缅甸HIV分子流行病学及与我国HIV流行的相关性[J].国际病毒学杂志,2010,17(2):43-49.
[10]Castellano C,Pastorsatorras R.Competing activation mechanisms in epidemics on networks[J].Scientific reports,2012,2(16):371.
[11]Yata M,Rouch H.Role of centrality for the identification of influential spreaders in complex networks[J].Phys Rev E Stat Nonlin Soft Matter Phys,2014,90(3):032812.
[12]王继宝,陈晓晨,段星,等.云南省德宏傣族景颇族自治州2012-2016年新报告HIV感染者流行病学特征分析[J].中华流行病学杂志,2017,38(10):1378-1381.
[2]Little SJ,Pond SLK,Anderson CM,et al.Using HIV Networks to Inform Real Time Prevention Interventions[J].PLoS One,2014,9(6):e98443.
[3]Oster AM,Wertheim JO,Hernandez AL,et al.Using Molecular HIV Surveillance Data to Understand Transmission between Subpopulations in the United States[J].Journal of Acquired Immune Deficiency Syndromes,2015,70(4):444.
[4]黎裕雪云,冯毅,阮玉华,等.HIV分子传播网络研究进展[J].中国艾滋病性病,2016,22(11):940-942.
[5]Helleringer S,Kohler HP.Sexual network structure and the spread of HIV in Africa:evidence from Likoma Island,Malawi[J].AIDS,2007,21(17):2323.
[6]李小杉,钟平,李伟,等.人类免疫缺陷病毒-1CRF01AE毒株在我国的分子传播网络分析[J].中华微生物学和免疫学杂志,2016,36(5):321-327.
[7]Yuan R,Cheng H,Chen LS,et al.Prevalence of different HIV-1subtypes in sexual transmission in China:a systematic review and meta-analysis[J].Epidemiology&Infection,2016,144(10):2144.
[8]Kusagawa S,Sato H,Watanabe S,et al.Genetic and serologic characterization of HIV type 1prevailing in Myanmar(Burma)[J].AIDS Research&Human Retroviruses,1998,14(15):1379.
[9]姚志红,郑永唐.缅甸HIV分子流行病学及与我国HIV流行的相关性[J].国际病毒学杂志,2010,17(2):43-49.
[10]Castellano C,Pastorsatorras R.Competing activation mechanisms in epidemics on networks[J].Scientific reports,2012,2(16):371.
[11]Yata M,Rouch H.Role of centrality for the identification of influential spreaders in complex networks[J].Phys Rev E Stat Nonlin Soft Matter Phys,2014,90(3):032812.
[12]王继宝,陈晓晨,段星,等.云南省德宏傣族景颇族自治州2012-2016年新报告HIV感染者流行病学特征分析[J].中华流行病学杂志,2017,38(10):1378-1381.