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目的了解上海市静安区2013年新发现的、未经抗病毒治疗的艾滋病病毒1型(HIV-1)感染者的亚型分布特征,为该区制定艾滋病防治策略提供科学依据。方法选取2013年新发现的HIV-l感染者血浆标本144份,运用反转录-聚合酶链反应(RT-PCR)扩增,进行DNA测序及系统进化树分析,并结合流行病学资料进行分析。结果⑴获得104份pol区基因片段,其中亚型分布显示,CRF01_AE亚型所占比例最大,为73.1%(76/104),其次为CRF07_BC为19.2%(20/104);B亚型为4.8%(5/104);CRF08_BC为1.9%(2/104);并发现新的重组体CRF 59_01B亚型为1.0%(1/104)。⑵HIV-1基因亚型与年龄分布(χ~2=17.72,P<0.05)、传播途径有统计学关联(χ~2=20.11,P<0.05),和CD4+T淋巴细胞分组(χ2=12.83,P<0.05)之间有统计学差异。⑶Logistic回归分析显示,50岁以上及基因亚型是HIV进展为艾滋病的主要影响因素。结论男男同性性传播是静安区HIV-1感染的主要传播途径,HIV-1感染者中病毒基因亚型具有多样化,应加强对感染者的基因亚型监测。
Objective To understand the distribution of subtypes of HIV-1 newly discovered in Jing’an District of Shanghai City in 2013 and to provide a scientific basis for the development of HIV / AIDS prevention and control strategies in this area. Methods A total of 144 plasma samples from newly infected HIV-1 infected persons were selected in 2013 and amplified by reverse transcription-polymerase chain reaction (RT-PCR). DNA sequencing and phylogenetic tree analysis were carried out and epidemiological data were used analysis. Results (1) 104 pol region gene fragments were obtained. The distribution of subtypes showed that CRF01_AE subtypes accounted for the largest proportion of 73.1% (76/104), followed by CRF07_BC (19.2%, 20/104) and subtype B 4.8 % (5/104); CRF08_BC was 1.9% (2/104); and the new recombinant CRF 59_01B subtype was found to be 1.0% (1/104). (2) The distribution of HIV-1 gene subtypes and age distribution (χ ~ 2 = 17.72, P <0.05) and the transmission pathways were statistically associated with the distribution of CD4 + T lymphocytes (χ2 = 12.83 , P <0.05). Logistic regression analysis showed that over 50 years of age and genotypes were the main influencing factors of HIV progression to AIDS. Conclusion Male and female homosexual transmission is the main route of transmission of HIV-1 infection in Jing’an District. The viral subtypes in HIV-1 infected persons are diversified, and the genotypes of infected persons should be strengthened.