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.
引文
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