云南瑞丽静脉药瘾人群HIV1感染者毒株env基因V3区序列测定研究

为了解云南瑞丽静脉药瘾人群HIV1感染者毒株的分子流行病学特征 ,运用套式聚合酶链反应 (nestedPCR)对来自云南静脉药瘾人群的 16株HIV1env基因V3区进行扩增 ,并对扩增片段进行DNA序列测定和分析。结果显示 ,与本地区共享序列相比 ,16株HIV1膜蛋白V3区氨基酸序列的株间变异为 0 %～ 2 3% ,平均为 7%。HIV1云南株膜蛋白V3区氨基酸共享序列与HIV1SF2株及美欧株共享序列同源性在 90 %以上 ,而与海地、日本及非洲等地的代表毒株同源性较低。结果表明 ,在进化上这16株HIV1毒株间有非常密切的关系。这一地区的流行毒株在这一时期以美欧株、HIV1SF2株及其衍生株为主。     

福建省2株麻疹病毒的分离与鉴定

[目的] 了解福建省目前流行的麻疹野病毒的型别与抗原性。[方法]细胞培养分离病毒;PT-PCR扩增病毒N基因碳末端450个核苷酸,并对其产物测定基因序列以定型;细胞中和试验进行抗原性分析。[结果]B95a细胞分离到了2株麻疹野病毒,Vero细胞未分离到,表明B95a细胞敏感性较高;分离到的病毒经PT-PCR及基因序列测定证实为麻疹野病毒H1基因型(中国流行的优势株);分离的野病毒株与疫苗株同时进行血清中和试验显示：目前使用的疫苗产生的抗体对流行的野病毒仍具有中和作用,但中和滴度低于疫苗株。[结论]在保证生物安全的前提下,B95a细胞是目前分离麻疹病毒的首选细胞;新变异来的麻疹H1基因型也在我省流行,且目前使用的疫苗所产生的抗体,在体外中和野毒株的滴度低于疫苗株。     

福建省一起流行性腮腺炎爆发的病毒分离及基因特征分析

目的对福建省一起流行性腮腺炎(腮腺炎)爆发疫情进行病毒分离,了解其基因特征。方法应用非洲绿猴肾细胞分离病毒,逆转录-聚合酶链反应扩增小疏水蛋白(Small Hydrophobic Protein,SH)基因片段,测序并分析其基因特征。结果从爆发点采集的4例标本中,分离到3株腮腺炎病毒,均属于G基因型。此福建株与国内其他省流行的F基因型病毒株核苷酸差异性>9%,与S(上海,Shanghai)79疫苗株SH基因核苷酸差异17.6%,与1999～2005年英国流行的G2基因亚型病毒株核苷酸同源性最高(97.4%～99.8%)。结论此起爆发为G基因型腮腺炎病毒引起,是否为输入性病毒?目前在中国使用的疫苗所产生的抗体能否完全阻断?需进一步加强监测。     

一对男男性接触HIV感染者体内毒株基因序列的分析

目的应用分子流行病学方法,以分析2名具有高危性行为的男男性接触者(MSM)间HIV-1病毒传播关系。方法对2名人类免疫缺陷病毒(HIV)感染者进行流行病学调查。应用巢式RT-PCR扩增HIV-1 pol区和gag区基因,经DNA测序后,结合流行病学资料,用遗传进化系统树比对的方法分析两感染者体内HIV-1毒株的亲缘关系。结果该2名感染者体内HIV-1毒株所属亚型分别为HIV-1 CRF07_BC和CRF01_AE,gag和pol基因之间的基因距离分别为0.125和0.096。结论该2名男男性接触者间不存在HIV-1传播关系。     

湖北省HIV-1 B′亚型核心蛋白基因序列分析

目的 分析湖北省人类免疫缺陷病毒(HIV-1)主要流行株核心蛋白(gag)基因P17/24区序列特征,了解其流行特点和变异规律.方法 对湖北省HIV-1主要流行区域进行流行病学调查,应用巢式聚合酶链反应对102例HIV-1感染者的gag基因P17/24区进行扩增,对阳性扩增样本进行基因测序和序列分析.结果 湖北省共发现4种HIV亚型和重组亚型,B'亚型占82.69%,B'/C重组毒株、CRF01-AE重组毒株各占7.69%,C亚型占1.92%;基因序列分析显示,湖北省HIV-1 B'亚型与我国河南和云南省等地的毒株有较高的同源性;氨基酸序列变异分析显示,HIV-1 B'亚型毒株gag基因P17/24区发生不同程度的变异,P17突变位点较多,P24较为保守.结论 B'亚型依然是湖北省HIV优势流行株,HIV-1在湖北省有加快流行和进一步复杂化的趋势.     

流行性出血热病毒株间抗原差异的研究——Ⅰ.病毒株的分离与鉴定

本文报告从流行性出血热(EHF)病人和鼠中分离出28株能在Vero-E_6细胞上繁殖并适应于乳小白鼠稳定传代的病原因子。用分离株感染的鼠脑切片和参考株EHF病毒A16株感染的Vero-E_6细胞滴片,同时以IFAT法进行特异性血清学试验和排除试验,二者检测结果一致,说明分离株为EHF病毒;用HI对所分离的24株病毒的免疫血清分型表明,病毒株来源于黑线姬鼠的为野鼠型毒株,来源于褐家鼠的主要为家鼠型毒株。进一步研究来源于不同疫源地类型疫区和潜在疫区毒株间的抗原性差异,将对EHF的防制有指导性意义。     

HIV流行毒株的DNA macroarray基因分型技术的研究

目的：建立一种特异、相对简便的HIV流行毒株基因分型新技术。方法：从HIV-1抗体阳性标本中提取HIV前病毒DNA。使用HIV-1型共用引物进行PCR扩增。同时设计一条型特异性的探针，然后通过制作DNA macroarray芯片，鉴别样本的HIV亚型。结果：DNAmacroarray分析可以检测我国HIV主要流行株基因型的特异性序列：B、C、CRF01-AE和CRF07-BC。结论：DNA macroarray方法对HIV亚型进行分析是可行的，可以在HIV流行病学调查中应用。     

急性出血性结膜炎病原学分子特征分析

目的 检测分析引发浙江省急性出血性结膜炎(AHC)爆发流行的病原学及毒株的分子特征.方法 采用荧光定量逆转录-聚合酶链反应方法直接从AHC患者眼拭子样本中检测肠道病毒(EV)和柯萨奇病毒A24变异株(CA24v)核酸;用Hep-2细胞分离病毒,对阳性分离物扩增病毒VP1基因和3C区片段,测定核苷酸序列,应用DNAMAN和MEGA软件进行同源性和进化分析.结果 3株浙江CA24v分离株VP1基因全长915个核苷酸(nt).3C区全长549 nt,均没有nt的插人和缺失;浙江分离株Zhejiang/13/08与CA24v原型株EH24/70在VP1和3C区核苷酸同源性分别为85.3%和86.5%,与2005年新加坡分离株Singapore/DSO-26/05和2007年广东分离株Guangdong/332/07株在VP1区和3C区的核苷酸同源性分别为97.0%～99.1%和96.7%～99.5%;浙江CA24v分离株在3C区进化树的Ⅲ基因亚型B分支上(GⅢ/B),在VP1进化树的CA24v Group2分支上.结论 引起2007-2008年浙江省急性出血性结膜炎爆发流行的病原为CA24v GⅢ亚型,该病毒最有可能来源于新加坡.     

我国治疗前HIV耐药毒株流行进展

HIV耐药毒株的流行影响了抗逆转录病毒治疗(ART)效果,降低了HIV感染者体内病毒抑制率并导致HIV的二代传播。HIV感染者尚不能治愈,需要终身服药。一旦由于某种原因导致治疗失败,可能会出现HIV耐药毒株,导致HIV耐药在我国未治疗人群中产生并传播。本文就我国治疗前HIV耐药毒株流行的研究进展进行了文献综述。     

我国首次从艾滋病病人分离到艾滋病病毒(HIV)

应用MT-4细胞,从1例美国籍来华旅游的艾滋病人血液中分离到1株病毒,经间接免疫荧光试验和蛋白印迹法证明,所分离的病毒为HIV。这是在我国首次分离成功HIV病毒,为我国开展艾滋病诊断和防治提供了自己的毒株。本文还报告了分离病毒和制备蛋白印迹法抗原带的改进方法,可以推广。     

Previous HIV testing among adults and adolescents newly diagnosed with HIV infection - National HIV Surveillance System, 18 jurisdictions, United States, 2006-2009

In 2006, CDC recommended human immunodeficiency virus (HIV) testing for adults, adolescents, and pregnant women in health-care settings and HIV testing at least annually for persons at high risk for HIV infection* to foster early detection, facilitate linkage to care, and improve health outcomes. Understanding previous HIV testing patterns among persons recently diagnosed with HIV infection can help in the design of HIV testing strategies that reduce the time between onset of HIV infection and its diagnosis. To assess previous HIV testing patterns among adults and adolescents newly diagnosed with HIV infection, CDC analyzed data for the period 2006-2009 from 18 jurisdictions participating in HIV incidence surveillance through CDC's National HIV Surveillance System (NHSS).? This report describes the results of that analysis, which indicated that among adults and adolescents for whom testing history information (THI) was available, 41% were diagnosed with HIV infection at their first HIV test, and 59% had a negative test at some point before HIV diagnosis. Groups with the highest percentage of persons testing HIV-negative ≤12 months before HIV diagnosis included those aged 13-29 years (33%), males with HIV transmission attributed to male-to-male sexual contact (29%), and whites (28%). These results demonstrate that many persons diagnosed with HIV infection have never been tested previously. Persons who are unaware of their HIV infection might not change their behavior to reduce the risk for transmission and will not be linked to care, resulting in worse health outcomes. Enhanced efforts are needed to increase annual HIV testing for populations at high risk for HIV infection to increase early detection.     

Estimating HIV incidence in the United States from HIV/AIDS surveillance data and biomarker HIV test results

The development of an human immunodeficiency virus (HIV) test that detects recent infection has enabled the U.S. Centers for Disease Control and Prevention (CDC) to estimate annual HIV incidence (number of new infections per year, not per person at risk) in the United States from data on new HIV and acquired immunodeficiency syndrome (AIDS) diagnoses reported to HIV/AIDS surveillance. We developed statistical procedures to estimate the probability that an infected person will be detected as recently infected, accounting for individuals choosing whether and how frequently to seek HIV testing, variation of testing frequency, the reporting of test results only for infected persons, and infected persons who never had an HIV-negative test. The incidence estimate is the number of persons detected as recently infected divided by the estimated probability of detection. We used simulation to show that, under the assumptions we make, our procedures have acceptable bias and correct confidence interval coverage. Because data on the biomarker for recent infection or on testing history were missing for many persons, we used multiple imputation to apply our models to surveillance data. CDC has used these procedures to estimate HIV incidence in the United States.     

The potential efficiency of routine HIV testing of hospital patients--data from a CDC sentinel hospital.

St. Paul-Ramsey Medical Center is a member of the Centers for Disease Control (CDC) Sentinel Hospital Surveillance Group. The authors have modified the surveillance group's protocol in order to calculate what percentage of the human immunodeficiency virus (HIV)-infected samples identified came from persons known by them to be HIV infected. All identifiers are still unlinked from the sample before testing for HIV. After 24 months, the HIV seroprevalence was 0.96 percent and the estimated cost of identifying a "new" seropositive at this site is $4,530 to $9,060. This range is a cost estimate; a typical laboratory charge for the HIV ELISA screen, if applied to such a testing program, would considerably increase this estimate. Modifications to the protocol design that would target patients in certain demographic groups (for example, men ages 15 to 44 years) or HIV-associated diseases might improve efficiency but could miss a significant number of HIV-infected patients. The efficiency of hospital-based HIV testing would likely decline after several years of practice. Although there are significant ethical problems with programs attempting routine hospital-based HIV testing, pilot testing may merit consideration in areas where the HIV-1 seroprevalence is greater than 1 percent.     

一种快速检测HIV抗体方法的评价

目的：探讨一种快速检测人类免疫缺陷病毒（HIV）抗体方法的敏感性和特异性,为艾滋病自愿咨询检测（VCT）及各种应急检测提供参考依据。方法：选择MSM调查人群血样1010份,平行用抗HIV-1／2快速检测（RT）试剂与抗HIV-1／2酶联免疫（ELISA）试剂进行检测,凡结果阳性者均用免疫印迹法（WB）进行确认。结果：710份血浆标本两种方法均有42份阳性,两者相符;300份全血标本用RT法检测,19份阳性,ELISA法22份阳性,3份不符标本后用血浆重复用RT法检测为阳性。所有阳性标本经WB确认均判为阳性。结论：HIV抗体快速检测试剂的使用需满足质量保证的要求并做好检测前后的咨询。建议使用经权威机构推荐的快速检测试剂;对于采供血机构,应使用ELISA法进行检测。     

HIV testing--United States, 2001

As of December 2001, a cumulative total of 816,149 cases of acquired immunodeficiency syndrome (AIDS) had been reported to CDC (1). One of CDC's national human immunodeficiency virus (HIV)--prevention goals for 2005 (Goal 2) is to increase the proportion of HIV-infected persons in the United States who know they are infected from an estimated 70% to 95% (2). A goal of the new CDC initiative, Advancing HIV Prevention: New Strategies for a Changing Epidemic, is to ensure that every HIV-infected person has the opportunity to be tested and has access to state-of-the-art medical care and prevention services needed to prevent HIV transmission (3). To characterize the prevalence of HIV-antibody testing among U.S. adults, CDC analyzed data from the 2001 Behavioral Risk Factor Surveillance System (BRFSS). The findings document variability in HIV testing prevalence by area and by sex within areas, underscoring the ongoing need to promote voluntary HIV counseling and testing that will provide persons with early knowledge of their HIV status and offer them access to appropriate counseling and treatment.     

Missed opportunities for earlier diagnosis of HIV infection--South Carolina, 1997-2005

In September 2006, CDC published revised recommendations for human immunodeficiency virus (HIV) testing in health-care settings to 1) increase early detection of HIV infection by expanding HIV screening of patients and 2) improve access to HIV care and prevention services (e.g., by conducting screening in locations such as emergency departments and urgent-care facilities, where persons who do not otherwise access HIV testing seek health-care services). HIV screening is now recommended for patients aged 13-64 years in all health-care settings after patients are notified that testing will be performed unless they decline (opt-out screening). This represents a substantial change from earlier recommendations to 1) offer HIV testing routinely to all patients only in health-care settings with high HIV prevalence and 2) conduct targeted screening on the basis of risk behaviors for patients in low-prevalence settings. This report examines HIV and acquired immunodeficiency syndrome (AIDS) case reporting in South Carolina before the 2006 recommendations were published. During 2001-2005, a total of 4,315 cases of HIV infection were reported in South Carolina. Of these, 41% were in persons (referred to as late testers) in whom AIDS was diagnosed within 1 year of their initial HIV diagnosis. Of these late testers, 73% made a total of 7,988 visits to a South Carolina health-care facility during 1997-2005 before their first reported positive HIV test. The diagnoses reported for 79% of these visits were not likely to prompt HIV testing under a risk-based testing strategy. These findings suggest that routine, opt-out HIV screening of all patients in health-care settings, rather than risk-based HIV testing, might result in substantially earlier HIV diagnoses in South Carolina.     

江苏省HIV-1基因型抗病毒治疗失败患者耐药检测结果分析

目的了解江苏省2010—2014年HIV-1感染者抗病毒失败人群的HIV-1耐药情况,为临床抗病毒治疗提供参考。方法根据耐药检测实验室网络收集江苏省2010—2014年的HIV-1基因型耐药检测结果,对各年度相关药物耐药情况、耐药基因位点及病毒基因亚型进行统计分析。结果 2010—2014年分别纳入样本74、113、197、278、346份,其中检测出现耐药结果的比率分别为68.92%、48.67%、51.27%、52.52%和57.80%。各年度间HIV-1主要耐药药物类似,核苷类主要有3TC、ABC、DDI和FTC,非核苷类药物以EFV和NVP为主。HIV-1对蛋白酶类药物耐药差别较大,且目前使用的LPV/r的耐药率在1%以下。年度间HIV-1主要耐药位点为184、181、190及103位,其中184位突变主要引起3TC和FTC耐药,而181、190、103位突变与EFV和NVP耐药相关。HIV-1病毒基因亚型均以CRF01_AE为主,且呈上升趋势。结论江苏省HIV感染者抗病毒治疗失败人群HIV-1基因型耐药率有上升趋势,应加强对抗病毒治疗患者的耐药检测,从而及时合理调整抗病毒治疗方案。     

Trends in HIV/AIDS diagnoses--33 states, 2001-2004

In 2003, more than 1 million persons in the United States were estimated to be living with human immunodeficiency virus (HIV) infection. As a result of advances in treatment with highly active antiretroviral therapy (HAART) since 1996, persons infected with HIV are living longer than before and progression to acquired immunodeficiency syndrome (AIDS) has decreased. Consequently, AIDS surveillance no longer provides accurate population-based monitoring of the current HIV epidemic. Therefore, CDC recommends that all states and territories adopt confidential, name-based surveillance systems to report HIV infection. This report describes the characteristics of persons for whom HIV infection was diagnosed during 2001-2004 and reported to 33 state and local health departments with name-based HIV reporting. The findings indicate that the rate of HIV diagnosis in these states decreased among non-Hispanic blacks from 2001 to 2004; however, the rate of HIV diagnosis among blacks remained disproportionately high. In 2004, the rate among blacks was 8.4 times higher than among whites. Improved knowledge of HIV status and access to care and prevention services is important to decrease the number of new HIV infections among those populations most affected.     

2013-2017年贵州省艾滋病患者HIV亚型分布

  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。