湖北省HIV-1分子流行病学研究

目的了解湖北省HIV-1基因型分布特征。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其中102例HIV-1感染者的env基因V3～V4区、gag基因P17/P24区和tat基因第一外显子区进行扩增，对各基因区阳性扩增样本进行序列测定，并对各基因区核苷酸进行序列分析。结果所有目标人群中共存在B^＋、C2种亚型以及CRF08-BC和CRF01-AE2种重组毒株，B^＋亚型在人群和地域上分布最广，涉及献血员、受血者以及二者的配偶和性乱人群，主要分布既往有偿献血员集中的地区。CRF08-BC、CRF01-AE重组主要涉及性乱人群，分布于经济发达的城市或地理位置偏南方的地区。C亚型为离散病例，主要涉及静脉毒品注射者。结论湖北省已由既往单一HIv-1 B^＋亚型转变为多种亚型、重组亚型流行的复杂局面，各亚型在省内高危人群和地域分布不平衡，各有特点，从总的亚型流行特征来看，HIV-1在湖北省有加快流行和进一步复杂化的趋势。

Study on molecular epidemiology of people infected with human immunodeficiency virus-1 in Hubei province

OBJECTIVE: To study the distribution of human immunodeficiency virus-1 (HIV-1) genotypes in Hubei province. METHODS: Epidemiological survey was carried out to HIV-1 carriers who were identified in Hubei province. HIV-1 env V3-V4, gag P17/24 and the first exon of tat region were amplified by nested-polymerase chain reaction(nPCR) .The sequences were determined, and phylogenetic analyses were then performed. RESULTS: 4 HIV-1 strains or circulating recombinant forms (CRFs) were identified in Hubei province with subtype B' the predominant which covered 5 kinds of populations including former blood donors, blood receivers, spouses of the infected people, sex workers and their clients, homosexuals, mainly distributed in the areas with many former blood donors. CRF08-BC and CRF01-AE were found distributed in economically more developed cities or southern area of the province, and the major transmission routes was through sexual contact. Only 1 patient, an injecting drug user, was identified having subtype C. CONCLUSION: Subtype B' was the main epidemic subtypes in Hubei province while CRF08-BC, CRF01-AE and subtype C were also circulating in the province, indicating the transmission of the disease might to become more complex.