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王征桦, 吴守丽, 张春阳, 邱月锋. 基于HIV分子传播网络分析福建省HIV流行病学特征[J]. 中国公共卫生, 2023, 39(12): 1526-1529. DOI: 10.11847/zgggws1141276
引用本文: 王征桦, 吴守丽, 张春阳, 邱月锋. 基于HIV分子传播网络分析福建省HIV流行病学特征[J]. 中国公共卫生, 2023, 39(12): 1526-1529. DOI: 10.11847/zgggws1141276
WANG Zhenghua, WU Shouli, ZHANG Chunyang, QIU Yuefeng. Epidemiological characteristics of newly reported HIV/AIDS patients in Fujian province, 2020: a molecular transmission network-based analysis[J]. Chinese Journal of Public Health, 2023, 39(12): 1526-1529. DOI: 10.11847/zgggws1141276
Citation: WANG Zhenghua, WU Shouli, ZHANG Chunyang, QIU Yuefeng. Epidemiological characteristics of newly reported HIV/AIDS patients in Fujian province, 2020: a molecular transmission network-based analysis[J]. Chinese Journal of Public Health, 2023, 39(12): 1526-1529. DOI: 10.11847/zgggws1141276

基于HIV分子传播网络分析福建省HIV流行病学特征

Epidemiological characteristics of newly reported HIV/AIDS patients in Fujian province, 2020: a molecular transmission network-based analysis

  • 摘要:
    目的 通过构建HIV分子传播网络,分析福建省HIV感染者的社会网络结构特征,指导精准防控、减少新发感染。
    方法 收集2020年福建省1336例全年新报告HIV感染者/艾滋病患者(HIV/AIDS)治疗前血样,采用自建基因型耐药检测方法获取基因序列,运用HIV-TRACE构建分子网络。
    结果 共获得908例RT-PCR基因序列,以男性为主(84.03%),年龄以20~59岁为主(76.76%),性传播为主要传播途径(93.83%),文化程度以文盲及小学占比最高(38.66%),婚姻状况中已婚者比例最高(46.92%);基因亚型分析显示以CRF07_BC和 CRF01_AE为主(782.49%);有48例研究对象发生耐药,耐药率为5.3%。HIV分子传播网络分析显示,在1.5%基因距离下入网率为41.52%(377/908),共形成108个传播簇,发现的最大的传播簇为CRF01_AE亚型,共有23个节点,节点数 > 4的传播簇共发现21个。logistic回归分析结果显示, ≥ 60岁(OR = 1.875,95%CI = 1.215~3.241)、亚型为CRF07_BC(OR = 2.112,95%CI = 1.632~3.211)和CRF01-AE(OR = 1.987,95%CI = 1.411~3.645)、已婚人群(OR = 1.713,95%CI = 1.245 ~ 2.487)入网率较高,而与未耐药者相比,耐药者(OR = 0.195,95%CI = 0.134~0.326)入网率较低。
    结论  福建省HIV分子传播网络成簇较多,入网率影响因素复杂多样,并且发现治疗前耐药比例较高,应引起重视。

     

    Abstract:
    Objective To describe epidemiological characteristics of newly reported human immunodeficiency virus/acquired immune deficiency syndrome (HIV/AIDS) patients in Fujian province through constructing a HIV molecular transmission network for effective prevention and control of HIV infection.
    Methods Blood samples were collected and HIV RNA were extracted from 1 136 newly reported antiretroviral therapy-naïve HIV/AIDS patients in Fujian province in 2020. With HIV subtype B primers, HIV gene sequences of the HIV/AIDS patients were obtained by reverse transcription PCR using a self-established genotypic drug resistance detection method. A molecular transmission network was constructed for the HIV/AIDS patients based on the analysis using HIV-TRACE.
    Results Of the 908 participants with valid HIV gene sequencing results, 763 (84.03%) were males; 697 (76.76%) were aged 20 – 59 years; 852 (93.83%) were infected via sexual transmission; 351 (38.66%) had low education (illiteracy or primary school education); and 426 (46.92%) were married. The predominant HIV genotypes for the participants were CRF07_ BC and CRF01_ AE, together accounting for 82.49% of the infections. Drug resistance was detected in 48 (5.3%) of the participants. Under the 1.5% gene distance threshold, 108 molecular transmission clusters were established for 377 (41.52%) of the participants, with the largest cluster of CRF01_ AE subtype, 23 cluster nodes, and 21 clusters having 4 or more nodes. The results of multivariate logistic regression analysis showed that the participants aged 60 years and older (odds ratio OR = 1.875, 95% confidence interval 95%CI: 1.215 – 3.241), being infected with subtype CRF07_ BC (OR = 2.112, 95%CI: 1.632 – 3.211) or CRF01_AE (OR = 1.987, 95%CI: 1.411 – 3.645), and being married (OR = 1.713, 95%CI: 1.245 – 2.487) were more likely to enter a molecular transmission network; but the participants having drug resistance were less likely to enter a molecular transmission network (OR = 0.195, 95%CI: 0.134 – 0.326) compared to those not having drug resistance.
    Conclusion Among HIV/AIDS patients in Fujian province, molecular transmission network-related HIV infection was prevalent and influence by multiple factors; drug resistance was also prevalent among antiretroviral therapy-naïve HIV/AIDS patients. The study results should be concerned in regional HIV/AIDS control and prevention.

     

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