云南德宏傣族景颇族自治州2017—2019年新报告HIV感染者基因亚型分布特征分析

段星; 张志一; 王继宝; 叶润华; 杨锦; 周素娟; 王译葵; 杨涛; 杨跃诚; 唐仁海; 何纳; 丁盈盈; 段松

doi:10.19428/j.cnki.sjpm.2022.21943

云南德宏傣族景颇族自治州2017—2019年新报告HIV感染者基因亚型分布特征分析

HIV subtypes in newly reported HIV-infected cases in Dehong Prefecture of Yunnan Province during 2017 to 2019

摘要

摘要:
目的分析2017—2019年云南省德宏傣族景颇族自治州（简称“德宏州”）新报告人类免疫缺陷病毒（HIV）感染者基因亚型分布特征，探究HIV流行情况及亚型分布特征随时间的变化趋势。
方法对德宏州2017—2019年新报告且血浆量>200 μL的HIV感染者标本进行核酸抽提，使用反转录⁃聚合酶链反应（RT⁃PCR）方法对HIV的gag、env和pol基因进行逆转录扩增，并对扩增产物测序，根据上述3个基因测序结果进行亚型确定。
结果 2017—2019年德宏州共报告HIV感染者3 287例，其中成功获得HIV的gag、env和pol基因亚型者1 813例，主要优势亚型为C亚型（28.4%，515/1 813）、BC重组亚型（22.0%，398/1 813）和CRF01_AE亚型（18.1%，329/1 813）。在中国籍与缅甸籍HIV感染者中均表现为B亚型、C亚型和CRF01_AE亚型所占构成比逐年下降，01/BC重组亚型、CRF07_BC亚型及CRF08_BC亚型的构成比逐年上升（χ²=75.212，P<0.001）。中国籍与缅甸籍不同HIV基因亚型的HIV感染者性别、年龄、婚姻状态、民族、文化程度和传播途径方面的构成比差异均有统计学意义（均P<0.05）。
结论德宏州HIV基因亚型分布随时间变化表现出更为复杂多样的特点，表现为BC重组亚型和独特重组型所占构成比明显增加。

Abstract:
Objective To determine the trend and influencing factors of HIV subtypes in newly reported HIV/AIDS cases in Dehong Dai and Jingpo Autonomous Prefecture （Dehong Prefecture） from 2017 to 2019.
Methods RNA extraction was conducted among newly reported HIV/AIDS cases in Dehong Prefecture from 2017 to 2019 whose plasma volume was more than 200 μL. The gag， env and pol genes were amplified by using RT-PCR and then sequenced to determine the subtypes.
Results A total of 3 287 HIV-infected cases were newly reported in Dehong from 2017 to 2019. The HIV gag， env and pol genotypes were determined in 1 813 cases. The major subtypes were subtype C （28.4%，515/ 1 813）， recombination form BC （22.0%，398/1 813） and CRF_01AE （18.1%，329/1 813）. Furthermore， the proportion of subtype B， subtype C and CRF01_AE decreased over years， whereas 01/BC， CRF07_BC and CRF08_BC increased over years in both Chinese and Burmese patients （χ²=75.212，P<0.001）. There were significant differences in gender， age， marital status， ethnicity， educational level and transmission route among Chinese and Burmese HIV-infected cases with diverse HIV genotypes （all P<0.05）.
Conclusion HIV subtypes in Dehong change over time， which demonstrates that the proportion of BC recombinant subtypes and unique recombinant subtypes increased significantly.

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