2013-2017年贵州省艾滋病患者HIV亚型分布

柳兴凤; 李志坚; 方星; 张信辉; 黄璐; 王欢; 肖智

doi:10.16462/j.cnki.zhjbkz.2019.12.017

2013-2017年贵州省艾滋病患者HIV亚型分布

doi: 10.16462/j.cnki.zhjbkz.2019.12.017

柳兴凤^{1, 2},
李志坚²,
方星²,
张信辉²,
黄璐²,
王欢³,
肖智^1, ,

1.
563000 遵义, 遵义医科大学贵州省普通高等学校脑科学特色重点实验室
2.
550000 贵阳, 贵州省疾病预防控制中心实验中心
3.
563000 遵义, 遵义医科大学贵州省教育厅传染病与生物安全重点实验室

基金项目:

贵州省教育厅项目 qian jiao he KY[2015]331

贵州省卫健委项目 gzwjkj2018-2-001

详细信息

通讯作者:
肖智, E-mail: 1643255058@qq.com

中图分类号: R181.8;R512.91
计量
- 文章访问数: 636
- HTML全文浏览量: 376
- PDF下载量: 36
- 被引次数: 0
出版历程
- 收稿日期: 2019-04-09
- 修回日期: 2019-06-11
- 刊出日期: 2019-12-10

Distribution of HIV subtypes in HIV/AIDS patients in Guizhou from 2013 to 2017

1.
Key Laboratory of Brain Science, Guizhou Institution of Higher Education, Zunyi Medical University, Zunyi 563000, China
2.
Guizhou Center of Disease Prevention and Control, Guiyang 550000, China
3.
Key Laboratory of infectious disease & Biosafety, Provincial Department of Education, Zunyi Medical University, Zunyi 563000, China

Funds:

Guizhou Provincial Department of Education Project qian jiao he KY[2015]331

Guizhou Provincial Health Commission Project gzwjkj2018-2-001

More Information

Corresponding author: Xiao Zhi, E-mail: 1643255058@qq.com

摘要

摘要: 目的调查贵州省接受抗逆转录病毒治疗（antiretroviral therapy，ART）的人类免疫缺陷病毒/艾滋病（human immunodeficiency virus/acquired immune deficiency syndrome，HIV/AIDS）患者的HIV亚型分布特征，为艾滋病防治提供参考。方法采用方便抽样策略，收集贵州省2013-2017年间8 583份抗病毒治疗半年以上的在治艾滋病患者血浆，采用面对面问卷调查、HIV检测等横断面调查。结果其中有1 511例HIV病毒抑制失败（病毒载量，viral load，VL>1 000 copies/ml），成功对1 410例（93.31%）HIV抑制失败患者的HIV pol基因进行基因分型。结果显示，51.42%为CRF01_AE基因型，26.67%为CRF07_BC基因型，16.1%为CRF08_BC基因型。结论通过对贵州省近年来HIV流行亚型和主要传播途径的变化分析，提示HIV基因突变引起亚型的改变应先于HIV主要传播途径的改变，及时监测HIV亚型变化可作为防治艾滋病的主要依据之一。
- 艾滋病 /
- 抗逆转录病毒治疗 /
- 人类免疫缺陷病毒 /
- 亚型分布
Abstract: Objective To investigate the molecular characteristics of human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) patients receiving antiretroviral therapy (ART) in Guizhou Province. Methods Using a convenience sampling strategy, 8 583 samples were collected in Guizhou and an investigation was conducted including face-to-face questionnaire interview and HIV testing. Results 1 511 cases failed in HIV suppression (viral load, VL>1 000 copies/ml). 1 410 cases (93.31%) were successfully genotyped with HIV pol gene, among which 51.42% were genotyped as CRF01_AE, 26.67% as CRF07_BC and 16.1% as CRF08_BC. Conclusion The subtype changes caused by HIV gene mutation should precede the changes of main transmission routes of HIV through the analysis in recent years. Timely monitoring the changes of HIV subtypes can be one of the main bases for the prevention and control of AIDS.
- AIDS /
- antiretroviral therapy /
- HIV /
- subtype distribution

HTML全文

表 1 基因检测引物序列

Table 1. Primer sequences for gene detection

引物类别	引物名称	方向	序列(5′-3′)
扩增引物	MAW26	外侧上游	TGGAAATGTGGAAAAGAAGGAC
	RT21	外侧下游	CTGTATTTCAGCTATCAAGTCTTTTGATGGG
	PRO1	内侧上游	CAGAGCCAACAGCCCCACCA
	RT20	内侧下游	CTGCCAATTCTAATTCTGCTTC
测序引物	PROS3	正向测序	GCCAACAGCCCCACCA
	RTAS	正向测序	CTCAGATTGGTTGCAC
	RTBS	正向测序	CCTAGTATAAACAATGAGACAC
	PROC1S	反向测序	GCTGGGTGTGGTATTCC
	RT20S3	反向测序	GTTCTAGCTCTGCTTC

下载: 导出CSV

表 2 2013-2017年贵州省艾滋病患者人口学特征

Table 2. Demographic characteristics of HIV/AIDS patients from 2013 to 2017

特征	例数	构成比(%)
总数	8 583
性别
男	5 433	63.30
女	3 150	36.70
年龄(岁)
≤25	816	9.51
26~	2 531	29.49
36~	2 421	28.21
>45	2 813	32.77
不详	2	0.02
婚姻
未婚	2 025	23.59
已婚或同居	4 727	55.07
离异或丧偶	1 808	21.06
不详	23	0.27
民族
汉族	6 725	78.35
其他	1 858	21.65
感染途径
同性性传播	956	11.14
异性性传播	5 920	68.97
吸毒传播	732	8.53
血液	47	0.55
母婴	34	0.40
不明确或不详	894	10.42
基线CD4⁺ (cells/mm³)
≤200	3 314	38.61
201~	3 137	36.55
351~	751	8.75
>500	261	3.04
缺失	1 120	13.05
治疗时间(年)
< 1	2 700	31.46
1~5	5 310	61.87
>5	533	6.21
不确定	40	0.47

下载: 导出CSV

表 3 1 410例艾滋病患者HIV亚型分布情况[n (%)]

Table 3. HIV subtypes among 1 410 HIV/AIDS patients[n (%)]

年份	CRF01_AE	CRF07_BC	CRF08_BC	CRF52_01B	CRF55_01B	CRF59_01B	CRF62_01B	CRF67_01B	A	B	C
2013	165(53.57)	84(27.27)	42(13.64)	0(0)	2(0.65)	0(0)	0(0)	0(0)	0(0)	3(0.97)	12(3.9)
2014	231(60.95)	87(22.96)	41(10.82)	1(0.26)	4(1.06)	0(0)	0(0)	1(0.26)	0(0)	4(1.06)	10(2.64)
2015	127(51.42)	67(27.13)	42(17.00)	0(0)	2(0.81)	0(0)	0(0)	0(0)	0(0)	2(0.81)	7(2.83)
2016	73(39.04)	63(33.69)	46(24.60)	0(0)	0(0)	0(0)	1(0.53)	0(0)	0(0)	1(0.53)	3(1.6)
2017	129(44.64)	75(25.95)	56(19.38)	0(0)	4(1.38)	1(0.35)	0(0)	0(0)	4(1.38)	1(0.35)	19(6.57)
合计	725(51.42)	376(26.67)	227(16.1)	1(0.07)	12(0.85)	1(0.07)	1(0.07)	1(0.07)	4(0.28)	11(0.78)	51(3.62)

下载: 导出CSV

参考文献(13)

[1]	Phillips AN, Cambiano V, Miners A, et al. Effectiveness and cost-effectiveness of potential responses to future high levels of transmitted HIV drug resistance in antiretroviral drug-naive populations beginning treatment: modelling study and economic analysis[J]. Lancet HIV, 2014, 1(2): e85-93. DOI: 10.1016/S2352-3018(14)70021-9.
[2]	Clutter DS, Jordan MR, Bertagnolio S, et al. HIV-1 drug resistance and resistance testing[J]. Infect Genet Evol, 2016, 46: 292-307. DOI: 10.1016/j.meegid.2016.08.031.
[3]	张福杰, 等. 国家免费艾滋病抗病毒药物治疗手册(第4版)[M]. 北京: 人民卫生出版社, 2016. Zhang FJ, et al. National handbook of free HIV/AIDS treatment (4th edition)[M]. Beijing: People's Medical Publishing House, 2016.
[4]	Zhang F, Haberer JE, WangY, et al. The Chinese free antiretroviral treatment program: challenges and responses[J]. AIDS, 2007, 21: 143-148. DOI: 10.1097/01.aids.0000304710.10036.2b.
[5]	Zhong P, Pan Q, Ning Z, et al. Genetic diversity and drug resistance ofhuman immunodeficiency virus type 1(HIV-1) strains circulating in Shanghai[J]. AIDS Res Hum Retroviruses, 2007, 23: 847-856. DOI: 10.1089/aid.2006.0196.
[6]	李兰娟, 任红, 高志良, 等. 传染病学(第8版)[M]. 北京: 人民卫生出版社, 2013: 108-118. Li LJ, Ren H, Gao ZL, et al. Epidemiology (8th edition)[M]. Beijing: People's Medical Publishing House, 2013: 108-118.
[7]	刘德纯. 我国艾滋病流行与传播30年回顾[J]. 新发传染病电子杂志, 2017, 2(1): 50-52. https://www.cnki.com.cn/Article/CJFDTOTAL-XFCR201701017.htm Liu DC. 30 years review of AIDS epidemic and spread in China[J]. Electronic Journal of Emerging Infectious Diseases, 2017, 2(1): 50-52. https://www.cnki.com.cn/Article/CJFDTOTAL-XFCR201701017.htm
[8]	Yu X, Yuan L, Huang Y, et al. Susceptibility of HIV-1 subtypes B', CRF07_BC and CRF01_AE that are predominantly circulating in China to HIV-1 entry inhibitors[J]. PLoS One, 2011, 6(3): e17605. DOI: 10.1371/journal.pone.001760511;6.
[9]	李健健, 李惠琴, 李敬云, 等. 云南省2012-2014年HIV-1流行毒株亚型分布特征[J]. 中国艾滋病性病, 2016, 22(3): 145-149. DOI: 10.13419/j.cnki.aids.2016.03.03. Li JJ, Li HQ, Li JY, et al. Characteristics and distribution of HIV-1 subtypes in Yunnan province[J]. Chin J AIDS STD, 2016, 22(3): 145-149. DOI: 10.13419/j.cnki.aids.2016.03.03.
[10]	孙显光, 李志坚, 程春林, 等. HIV-1基因亚型变化与贵州省艾滋病流行特征分析[J]. 实用医学杂志, 2012, 28(15): 2606-2608. DOI: 10.3969/j.issn.1006-5725.2012.15.055. Sun XG, Li ZJ, Cheng CL, et al. Change of HIV-1 genotype and analysis of AIDS epidemic characteristics in Guizhou province[J]. The Journal of Practical Medicine, 2012, 28(15): 2606-2608. DOI: 10.3969/j.issn.1006-5725.2012.15.055.
[11]	邵一鸣, 赵峰, 杨维中. 等. 我国西南西北地区吸毒人群重组人类免疫缺陷病毒1型毒株的发现[J]. 中华实验和临床病毒学杂志, 1999, 13(2): 109. DOI: 10.3760/cma.j.issn.1003-9279.1999.02.002. Shao YM, Zhao F, Yang WZ, et al. The identification of recombinant HIV-1 strains in IDUs in southwest and northwest China[J]. Chin J Exp Clin Virol, 1999, 13(2): 109. DOI: 10.3760/cma.j.issn.1003-9279.1999.02.002.
[12]	Kandathil AJ, Ramalingam S, Kannangai R, et al. Molecular epidemiology of HIV[J]. Indian J Med Res, 2005, 121(4): 333-344.
[13]	Nabatov AA, Pollakis G, Linnem ann T, et al. Intrapatient alterations in the human immunodeficiency virus type 1 gp120 V1V2 and V3 regions differentially modulate coreceptor usage, virus inhibition by CC/CXC chemokines, soluble CD4, and the b12 and 2G12 monoclonal antibodies. [J]. J Virol, 2004, 78(1): 524-530. DOI: 10.1128/jvi.78.1.524-530.2004.