云南省2014―2018年HIV-1流行毒株遗传变异及基因亚型分布

周熙姝; 李健健; 张米; 刘家法; 杨壁珲; 潘小满; 董兴齐

doi:10.16462/j.cnki.zhjbkz.2020.07.009

云南省2014―2018年HIV-1流行毒株遗传变异及基因亚型分布

doi: 10.16462/j.cnki.zhjbkz.2020.07.009

周熙姝^{1, 2},
李健健²,
张米²,
刘家法²,
杨壁珲²,
潘小满²,
董兴齐^{1, 2, ,}

1.
671000 大理, 大理大学公共卫生学院流行病与卫生统计学系
650301 昆明, 云南省传染病医院, 云南省艾滋病关爱中心

周熙姝与李健健为共同第一作者

基金项目:

“十三五”科技重大专项 2018ZX10721102-002

云南省教育厅科学研究基金项目 2019Y0260

云南省高层次卫生技术人才培养经费资助项目 H-2018050

详细信息

通讯作者:
董兴齐, E-mail:dongxq8001@126.com

中图分类号: R181
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出版历程
- 收稿日期: 2020-01-27
- 修回日期: 2020-05-22
- 刊出日期: 2020-07-28

Genetic variation and genotype distribution of HIV-1 epidemic strains in Yunnan Province from 2014 to 2018

1.
Epidemiology and Health Statistics, School of Public Health, Dali University, Dali 671000, China
Yunnan Infectious Disease Hospital, Yunnan Provincial AIDS Care Center, Kunming 650301, China

Funds:

"The 13th Five-Year" Science and Technology Major Project 2018ZX10721102-002

Yunnan Provincial Department of Education Science Research Fund Project 2019Y0260

Yunnan Health Training Project of High Level Talents H-2018050

More Information

Corresponding author: DONG Xing-qi, E-mail:dongxq8001@126.com

摘要

摘要: 目的调查云南省2014―2018年人类免疫缺陷病毒1（human immunodeficiency virus type 1，HIV-1）毒株基因亚型和重组型流行分布情况及其原始传播溯源。方法收集2014―2018年云南省16个州（市）2 604例在定点医院随访的HIV感染者或艾滋病患者的血样及流行病学信息，扩增HIV-1pol区基因，应用Genotyping和BLAST在线分析工具及软件MEGA 6.06确定毒株亚型，通过计算基因距离和系统进化树分析鉴定HIV-1重组型，阐明云南省HIV-1基因亚型的地区和人群分布特征。结果经扩增后共获得1 843条pol区序列，云南省HIV-1毒株主要亚型占比为CRF08_BC 55.8%，CRF07_BC 13.4%，CRF01_AE 14.3%，C亚型3.1%，B（B'）亚型2.6%，独特重组型（unique recombinant forms，URFSs）8.1%，其他2.7%。其中，CRF08_BC为最常见亚型。HIV-1基因型分布在年龄，感染途径，民族上的差异均有统计学意义（均有P < 0.05）。16个州（市）各亚型的分布均有差异（均有P < 0.05）。其中，德宏、保山和怒江主要以CRF01_AE为主，丽江和迪庆主要以CRF07_BC为主，其余地州主要以CRF08_BC为主。结论云南省16个州（市）HIV-1亚型以CRF08_BC流行为主，各种常见亚型均存在，仍有新型流行重组型（circulating recombinant forms，CRFs）出现，与2012―2014年的资料相比较，在地区、民族、年龄和感染途径方面有变化，应密切监测。
- 人类免疫缺陷病毒-1 /
- 流行毒株 /
- 亚型 /
- 分布特征 /
- 变异
Abstract: Objective To investigate the distribution of human immunodeficiency virus type 1(HIV-1) strain genotypes and recombinants, simultaneously trace original transmission of which in Yunnan Province from 2014 to 2018. Methods A total of 2 604 HIV/acquired immune deficiency syndrome(AIDS) plasma specimens with epidemiological information were collected during 2014 to 2018 from 16 prefectures of Yunnan Province. HIV-1 pol genes were amplified, Genotyping, BLAST tool of online analysis and MEGA 6.06 software were used to determine strain subtypes. By calculating genetic distance and phylogenetic tree analysis, we elucidated the distribution characteristics of HIV-1 gene subtypes in Yunnan Province. Results A total of 1 843 pol sequences were successfully amplified and sequenced. The major subtypes with proportion of HIV-1 strains in our province are CRF08_BC (55.8%), CRF07_BC (13.4%), CRF01_AE (14.3%), C subtype (3.1%), B (B') subtype (2.6%), unique recombinant forms(URFSs) (8.1%), and others (2.7%), respectively. CRF08_BC was the dominant subtype compared with other subtypes. There were statistically significant differences in the distribution of HIV-1 genotypes in age, infected routes, and ethnicity(all P < 0.05). Moreover, significantly differences of HIV-1genotypes distribution were also found between 16 prefectures of Yunnan Province(all P < 0.05). Among them, Dehong, Baoshan and Nujiang were dominated by CRF01-AE subtype, Lijiang and Diqing were dominated by CRF07-BC subtype, and the rest prefectures were dominated by CRF08_BC. Conclusions The CRF08_BC is the predominant epidemic HIV-1 subtype in 16 prefectures of Yunnan Province, and all kinds of HIV common subtypes exist. New circulation recombinant forms(CRFs) are still emerging. Compared with the data from 2012 to 2014, the subtypers of HIV-1 gene in Yunnan Province have changed in terms of areas, ethnicity, ages and transmitted routes, which should be closely monitored.
- Human immunodeficiency virus type 1 /
- Prevalent strains /
- Genetic subtype /
- Distribution characteristics /
- Variation

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图 1 云南省2014―2018各地州传播途径分布图

Figure 1. Distribution of HIV-1 infection routes in prefectures of Yunnan Province from 2014 to 2018

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图 2 云南省2014―2018年亚型分布图

Figure 2. Genotype distribution in Yunnan Province from 2014 to 2018

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图 3 云南省2014-2018年未知重组毒株系统发育树

注：黑点代表未知重组毒株，其余为参考株。

Figure 3. Neighbor-joining phylogenetic tree of URFs in Yunnan Province form 2014 to 2018

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表 1 云南省1 843例HIV/AIDS病人人口学特征

Table 1. Demographic characteristics of 1 843 HIV/AIDS patients from 2014 to 2018

项目	例数(例)	构成比(%)
性别
男	1211	65.7
女	632	34.3
年龄(岁)
≤15	39	2.1
16~	325	17.6
31~	925	50.2
46~	408	22.1
≥61	146	7.9
民族
汉	1 269	68.9
彝	153	8.3
白	61	3.3
傣	116	6.3
其他	241	13.1
不详	3	0.2
传播途径
异性性传播	1 346	73.0
同性性传播	31	1.7
静脉药瘾	362	19.6
母婴	35	1.9
血液传播	12	0.7
职业暴露	1	0.0
不详	56	3.0

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表 2 云南省1 843例HIV/AIDS病人人口学特征

Table 2. Demographic characteristics of 1 843 HIV/AIDS patients from 2014 to 2018

特征	例数(%)	B(%)	CRF01_AE(%)	CRF07_BC(%)	CRF08_BC(%)	URFs(%)^c	C(%)	其他^a	χ²值	P值
性别									4.878	0.560
男	1 211(65.7)	33(2.7)	181(14.9)	165(13.7)	663(54.7)	94(7.8)	43(3.6)	32(2.6)
女	632(34.3)	14(2.2)	82(13.0)	82(13.0)	366(57.9)	56(8.9)	15(2.4)	17(2.6)
年龄(岁)									49.516	< 0.001
≤15	39(2.1)	2(5.1)	9(23.1)	3(7.7)	17(43.6)	5(12.8)	1(2.6)	2(5.1)
16~	325(17.6)	5(0.3)	71(21.8)	53(16.3)	154(47.4)	25(7.7)	6(1.8)	11(3.5)
31~	925(50.2)	20(2.2)	116(12.5)	128(13.8)	538(58.2)	73(7.9)	25(2.7)	25(2.7)
46~	408(22.1)	16(3.9)	51(12.5)	45(11.0)	229(56.2)	37(9.1)	21(5.1)	9(2.2)
≥61	1 46(7.9)	4(2.7)	16(11.0)	18(12.3)	91(62.4)	10(6.8)	5(3.4)	2(1.4)
民族									29.356	< 0.001
汉	1 269(68.9)	20(1.6)	175(13.8)	187(14.7)	728(57.4)	93(7.3)	34(2.7)	32(2.5)
其他^b	574(31.1)	27(4.7)	88(15.3)	60(10.5)	301(52.4)	57(9.9)	24(4.2)	17(3.0)
传播途径									< 0.001	< 0.001
异性性传播	1 346(73.0)	38(2.8)	216(16.0)	167(12.5)	744(55.3)	104(7.7)	39(2.9)	38(2.8)
同性性传播	31(1.7)	0(0.0)	13(41.9)	3(9.7)	8(25.8)	4(12.9)	0(0.0)	3(9.7)
静脉药瘾	362(19.6)	7(1.9)	13(3.6)	61(16.9)	225(62.2)	34(9.4)	18(4.9)	4(1.1)
母婴	35(1.9)	1(2.9)	9(25.7)	4(11.4)	15(42.9)	3(8.6)	1(2.8)	2(5.7)
血液传播	12(0.7)	0(0.0)	6(50.0)	1(8.3)	4(33.4)	1(8.3)	0(0.0)	0(0.0)
职业暴露	1(0.0)	0(0.0)	0(0.0)	1(100.0)	0(0.0)	0(0.0)	0(0.0)	0(0.0)
不详	56(3.0)	1(1.8)	6(10.7)	10(17.8)	33(58.9)	4(7.1)	0(0.0)	2(0.0)
合计	1 843(100.0)	47(2.6)	263(14.3)	247(13.4)	1 029(55.8)	150(8.1)	58(3.1)	49(2.7)
注：^a其他亚型(例数)依次为CRF57_BC(10)、CRF62_BC(9)、CRF85_BC(9)、CRF86_BC(7)、CRF87_cpx(4)、CRF64_BC(3)、CRF91_01C(3)、CRF55_01B(2)、A(1)、CRF96_cpx(1)；^b其他民族(例数)依次为彝族(153)、白族(61)、傣族(116)、佤族(54)、哈尼族(54)、景颇族(36)、回族(30)、傈僳族(23)、苗族(21)、壮族(16)、布朗族(2)、拉祜族(2)、德昂族(1)、黎族(1)、纳西族(1)、不详(3)；^c独特重组型(unique recombinant forms，URFs)。

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表 3 云南省各地州HIV-1流行毒株亚型分布[n(%)]

Table 3. Genotype distribution of HIV-1 epidemic strains in prefectures of Yunnan Province[n(%)]

城市	例数	B	CRF01_AE	CRF07_BC	CRF08_BC	URFs	C	其他	χ²值	P值
版纳	47(100.0)	1(2.1)	18(38.2)	4(8.5)	19(40.4)	3(6.4)	0(0.0)	2(4.3)	679.921	< 0.001
德宏	138(100.0)	22(15.9)	18(13.0)	6(4.3)	11(8.0)	41(29.7)	28(20.3)	12(8.7)
临沧	123(100.0)	4(3.3)	10(8.1)	3(2.4)	95(77.2)	4(3.3)	2(1.6)	5(4.1)
红河	347(100.0)	1(0.3)	39(11.2)	33(9.5)	248(71.5)	20(5.8)	6(1.7)	0(0.0)
玉溪	63(100.0)	0(0.0)	8(12.7)	9(14.3)	42(66.7)	3(4.8)	1(1.6)	0(0.0)
曲靖	91(100.0)	0(0.0)	6(6.6)	25(27.5)	52(57.1)	4(4.4)	1(1.1)	3(3.3)
昆明	273(100.0)	2(0.7)	45(16.5)	64(23.4)	132(48.4)	23(8.4)	5(1.8)	2(0.7)
保山	93(100.0)	8(8.6)	33(35.5)	5(5.4)	13(14.0)	18(19.4)	4(4.3)	12(12.8)
文山	100(100.0)	0(0.0)	24(24.0)	3(3.0)	68(68.0)	2(2.0)	3(3.0)	0(0.0)
普洱	108(100.0)	1(0.9)	23(21.3)	12(11.1)	64(59.3)	5(4.6)	2(1.9)	1(0.9)
大理	185(100.0)	1(0.5)	11(5.9)	19(10.3)	132(71.4)	14(7.6)	5(2.7)	3(1.6)
昭通	159(100.0)	2(1.3)	11(6.9)	31(19.5)	104(65.4)	4(2.5)	0(0.0)	7(4.4)
楚雄	73(100.0)	1(1.4)	6(8.2)	20(27.4)	42(57.5)	2(2.7)	0(0.0)	2(2.7)
迪庆	3(100.0)	0(0.0)	0(0.0)	2(66.7)	1(33.3)	0(0.0)	0(0.0)	0(0.0)
怒江	29(100.0)	3(10.3)	10(34.6)	7(24.1)	4(13.8)	4(13.8)	1(3.4)	0(0.0)
丽江	11(100.0)	1(9.0)	1(9.0)	4(36.6)	2(18.1)	3(27.3)	0(0.0)	0(0.0)

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表 4 不同亚型之间的基因距离

Table 4. Genetic distances in different genotypes

结构基因	CRF01_AE(例数)(n=261)	CRF07_BC(例数)(n=303)	CRF08_BC(例数)(n=1025)
pol	0.094±0.007	0.088±0.007	0.069±0.008

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