广西柳州1998—2018年新发现HIV阳性者基因亚型亚簇变化

目的 了解广西柳州1998—2018年新发现HIV阳性者基因亚型亚簇变化情况。方法 选取HIV阳性者,采集全血标本进行DNA提取、pol基因区扩增、测序和判定亚型。采用趋势卡方检验分析不同时间段亚型亚簇变化情况。结果 自2007年起检测发现CRF01_AE 的cluster 3和cluster 4两个亚簇,自2010年起检测发现CRF55_01B亚型。广西柳州地区流行的亚型、亚簇种类在增加。1998—2006年、2007—2009年、2010—2014年和2015—2018年这四个时间段,CRF01_AE亚型的构成比分别为95.3%（346/363）、96.7%（734/759）、94.8%（1 536/1 620）和88.0%（499/567）;CRF01_AE亚型cluster 1的构成比分别为93.4%（339/363）、91.8%（697/759）、89.3%（1 447/1 620）和79.5%（451/567）,趋势卡方检验表明CRF01_AE亚型和cluster 1感染者的构成比呈下降趋势（P<0.01）。CRF55_01B亚型在2010—2014年和2015—2018年分别发现为7和12人。结论 CRF01_AE为广西柳州市的主要流行亚型,但该亚型感染者的构成比有下降趋势;该地区CRF01_AE亚型中亚簇和HIV亚型种类的增加,提示可能存在新的HIV毒株传入。     

广西壮族自治区低档场所中老年嫖客与暗娼HIV-1感染者基因亚型研究

目的 了解广西壮族自治区低档场所中老年嫖客与暗娼的HIV-1感染者病毒基因亚型特征及传播规律。方法 采用方便抽样的方法,于2012年对广西壮族自治区4个城市和9个县（区）低档场所的嫖客（年龄≥50岁）与暗娼开展分子流行病学调查,进行HIV-1抗体筛查,对HIV-1抗体阳性者血浆进行pol区基因片段扩增和序列测定,对获得的基因序列进行系统进化树构建并鉴定毒株的基因亚型,分析毒株亚型分布特征及传播规律。结果 共招募4 048例中老年嫖客和784例低档暗娼,共发现116例HIV-1抗体阳性,中老年嫖客与暗娼的HIV-1抗体阳性检出率分别为2.5%（103/4 048）、1.7%（13/784）,对其中84例HIV-1抗体阳性者进行基因扩增和序列测定,53例获得基因序列（中老年嫖客48例、暗娼5例）。发现3种基因亚型,均为重组株,CRF01_AE占90.6%（48/53）,CRF08_BC占7.5%（4/53）,CRF07_BC占1.9%（1/53）。经系统进化树分析发现,48例CRF01_AE流行毒株聚集成2个传播簇Cluster 1和2;4例CRF08_BC聚集成1个传播簇。在CRF01_AE Cluster 1中又形成4个亚簇C1-SC1、2、3、4,各亚簇对象来源于同一处或相邻低档场所、或与同一省道毗邻乡镇的低档场所。结论 广西壮族自治区低档场所中老年嫖客与暗娼HIV-1感染者流行毒株仍以CRF01_AE为主,以同一处或相邻低档场所或毗邻乡镇呈小范围聚集,当地HIV-1阳性的中老年嫖客与暗娼可能是该人群易感者毒株快速传播的重要传染源。     

中国南方四省区流行的HIV-1 CRF01_AE病毒株基因特征研究

Objective To analyze the genetic characteristics of HIV-1 CRF01_AE strains prevailing in. the four provinces of southern China. Methods Plasma samples were collected from the newly diagnosed HIV-1 individuals reported in 2006 in Guangdong, Guangxi, Jiangxi and Hunan province. The gag and env gene fragments were amplified from RNA template extracted from plasma using RT and nested PCR methods. CRF01_AE sequences were analyzed by phylogcnetie methods and characterized by calculating the genetic distance and Entropy analysis. Results Two main epidemic clusters were found to exist in the CRF01 AE strains from 210 HIV-1 CRF01 AE infected individuals collected in the 4 provinces, southern China. It was found that no international reference strain was closely correlated with cluster Ⅰ , which including 123 samples. The strains in cluster Ⅱ, consisting 57 cases of samples, were closely related with the strains identified in Vietnam. Genetic distance analysis of gag and env genes showed that the diversity of cluster Ⅰ was obviously less than that of cluster Ⅱ. Data on nucleotide polymorphism showed that nucleotides compositions of 42 sites in gag and 40 sites in env wer esignificantly different between the two clusters. When compared with cluster Ⅱ , the polymorphism decreased at 61 nucleotide sites but increased at 21 sites in cluster Ⅰ. Conclusion This was the first report describing that two main epidemic clusters were existed in CRF01_AE strains prevailing in the 4 provinces, Southern China. The vires in cluster Ⅰ was the dominant strain in this region, with shorter period of circulation and higher proportion seen in the HIV-infected population, which might belong to CRF01_AE strain with certain features facilitating the spread of the virus. The virus in cluster Ⅱ was highly homology with the CRF01_AE strains from Vietnam, and seemed to have had several events of epidemics in populations in border regions of China and Vietnam.     

艾滋病抗病毒治疗耐药的研究进展

高效抗逆转录病毒治疗(Highly Active Antiretroviral T h e r a p y, H A A R T)是华裔美籍著名科学家何大一(D a v i d H o)在1996年第十一届(温哥华)国际艾滋病大会上提出的对艾滋病的治疗方法,并在临床上广泛运用.HAART的提出是当今艾滋病(AIDS)科学研究的一大成就,不仅使艾滋病抗病毒(HIV)感染者和AIDS患者得以治疗,使病死率和发病率下降,而且大大提高了HIV感染人群的生命质量[1].     

广西部分吸毒人群丙型肝炎病毒及艾滋病病毒感染情况调查分析

目的了解我区吸毒人群中丙型肝炎病毒（HCV）及艾滋病病毒（HIV）感染和两者合并感染的情况,为制定艾滋病及丙型肝炎的防治措施提供理论依据。方法对我区部分在押的吸毒者共计3 000名作为调查对象,制定统一的调查问卷进行调查,并采集静脉血,分离血清,用酶联免疫吸附试验（ELISA）夹心法检测HCV抗体和HIV抗体,当HIV抗体阳性时则用蛋白免疫印迹试验（Western Blotting,WB）进行HIV抗体确证实验。结果在3 000名吸毒患者中,男性占88.4%,女性占11.6%;总的HCV抗体阳性率是85.6%,HIV抗体阳性率是18.2%,其中静脉注射吸毒者（IDUs）HCV抗体阳性2 553名,感染率为86.1%,口吸吸毒者HCV抗体阳性21名,感染率60.0%;口吸吸毒人群中HIV抗体阳性3名,感染率为8.56%,静脉吸毒人群中HIV抗体阳性543名,感染率18.31%;HCV抗体阳性合并HIV抗体阳性有537名,感染率为20.86%。结论广西吸毒人群的HCV感染率较高,尤其是静脉注射吸毒人群,应当加强对吸毒人群的综合干预措施,控制HCV及HIV的传播,降低新发感染。     

广西上林县出国淘金返乡人员艾滋病流行病学调查分析

目的了解2013年上林县出国淘金返乡人员艾滋病病毒(HIV)感染状况及流行病学特征,为制定艾滋病防治措施提供科学依据。方法收集2013年在上林县疾病预防控制中心接受HIV抗体筛查的返乡人员信息,分析其艾滋病感染情况及相关危险行为。结果 4 237名出国淘金返乡人员以男性为主,占99.13%;年龄以20~49岁的青壮年为主,占90.02%;婚姻状况以已婚有配偶为主,占93.13%,文化程度为中小学居多,占59.88%;外出务工时间多在10~19个月,占49.66%;主要务工地为非洲加纳,占99.08%。4 200例男性调查对象中,在出国务工期间与境外当地女子有非婚异性性行为史的比例为6.17%,安全套使用率为82.24%。HIV抗体阳性6人,阳性率为0.14%;对3例进行分子分型,均为CRF01-AE亚型。结论出国淘金返乡人员存在HIV感染风险,应加强对该类人群艾滋病监测与防控。     

高危人群HIV急性期/早期感染检测策略应用研究

目的探索适合于高危人群HIV急性期/早期感染的检测策略,减少窗口期漏检。方法收集来自广西的MSM人群专项调查样本,分别利用抗体诊断试剂(ELISA)、抗原抗体诊断试剂(ELISA)、抗原抗体诊断试剂(胶体金)、蛋白免疫印迹试验(WB)以及核酸检测建立四种检测策略,对常规策略与四种检测策略的检测结果进行对比和分析。结果 3 253份调查样本中,策略一检测出抗体阳性、核酸阳性分别为304例、10例;策略二检测出抗体阳性、核酸阳性分别为304例、14例;策略三检测出抗体阳性、核酸阳性分别304例、17例;策略四检测出抗体阳性、核酸阳性分别为304例、20例。策略一至四的检测敏感性分别为96.91%、98.15%、99.07%、100.00%,四种策略对HIV急性期/早期感染者的检测能力优于常规策略。确证结果不确定或阴性而核酸结果阳性的病毒载量值均大于5 000拷贝/ml,提示可能为HIV急性期/早期感染。结论在HIV感染率较高的高危人群中,采用抗原抗体诊断试剂结合核酸检测方法可以检出HIV急性期/早期感染者,提高阳性检出率,四种检测策略各有优缺点,应根据实验室条件、样本量和目的选择使用。     

中国南方四省区流行的HIV-1 CRF01_AE病毒株基因特征研究

Objective To analyze the genetic characteristics of HIV-1 CRF01_AE strains prevailing in. the four provinces of southern China. Methods Plasma samples were collected from the newly diagnosed HIV-1 individuals reported in 2006 in Guangdong, Guangxi, Jiangxi and Hunan province. The gag and env gene fragments were amplified from RNA template extracted from plasma using RT and nested PCR methods. CRF01_AE sequences were analyzed by phylogcnetie methods and characterized by calculating the genetic distance and Entropy analysis. Results Two main epidemic clusters were found to exist in the CRF01 AE strains from 210 HIV-1 CRF01 AE infected individuals collected in the 4 provinces, southern China. It was found that no international reference strain was closely correlated with cluster Ⅰ , which including 123 samples. The strains in cluster Ⅱ, consisting 57 cases of samples, were closely related with the strains identified in Vietnam. Genetic distance analysis of gag and env genes showed that the diversity of cluster Ⅰ was obviously less than that of cluster Ⅱ. Data on nucleotide polymorphism showed that nucleotides compositions of 42 sites in gag and 40 sites in env wer esignificantly different between the two clusters. When compared with cluster Ⅱ , the polymorphism decreased at 61 nucleotide sites but increased at 21 sites in cluster Ⅰ. Conclusion This was the first report describing that two main epidemic clusters were existed in CRF01_AE strains prevailing in the 4 provinces, Southern China. The vires in cluster Ⅰ was the dominant strain in this region, with shorter period of circulation and higher proportion seen in the HIV-infected population, which might belong to CRF01_AE strain with certain features facilitating the spread of the virus. The virus in cluster Ⅱ was highly homology with the CRF01_AE strains from Vietnam, and seemed to have had several events of epidemics in populations in border regions of China and Vietnam.     

2004～2005年广西HIV-1耐药横断面调查

目的 了解广西壮族自治区未接受抗病毒治疗的HIV感染者和已经接受抗病毒治疗一段时间的AIDS病人中的耐药情况.方法 收集我区2004～2005年部分HIV感染者的伞血标本201份,其中未接受抗病毒治疗的56人(27.86%),已接受抗病毒治疗的145人(72.14%),分别对他们进行问卷调查,并采集10毫升的抗凝血,分...     

中国南方四省区流行的HIV-1 CRF01_AE病毒株基因特征研究

Objective To analyze the genetic characteristics of HIV-1 CRF01_AE strains prevailing in. the four provinces of southern China. Methods Plasma samples were collected from the newly diagnosed HIV-1 individuals reported in 2006 in Guangdong, Guangxi, Jiangxi and Hunan province. The gag and env gene fragments were amplified from RNA template extracted from plasma using RT and nested PCR methods. CRF01_AE sequences were analyzed by phylogcnetie methods and characterized by calculating the genetic distance and Entropy analysis. Results Two main epidemic clusters were found to exist in the CRF01 AE strains from 210 HIV-1 CRF01 AE infected individuals collected in the 4 provinces, southern China. It was found that no international reference strain was closely correlated with cluster Ⅰ , which including 123 samples. The strains in cluster Ⅱ, consisting 57 cases of samples, were closely related with the strains identified in Vietnam. Genetic distance analysis of gag and env genes showed that the diversity of cluster Ⅰ was obviously less than that of cluster Ⅱ. Data on nucleotide polymorphism showed that nucleotides compositions of 42 sites in gag and 40 sites in env wer esignificantly different between the two clusters. When compared with cluster Ⅱ , the polymorphism decreased at 61 nucleotide sites but increased at 21 sites in cluster Ⅰ. Conclusion This was the first report describing that two main epidemic clusters were existed in CRF01_AE strains prevailing in the 4 provinces, Southern China. The vires in cluster Ⅰ was the dominant strain in this region, with shorter period of circulation and higher proportion seen in the HIV-infected population, which might belong to CRF01_AE strain with certain features facilitating the spread of the virus. The virus in cluster Ⅱ was highly homology with the CRF01_AE strains from Vietnam, and seemed to have had several events of epidemics in populations in border regions of China and Vietnam.