一起家庭内HIV-1感染的分子流行病学研究

[目的]采用现场流行病学和分子流行病学相结合的方法,以阐明家庭内成员HIV-1病毒传播关系。[方法]通过定性流行病学,调查一家庭内各成员有关HIV-1感染及其相关因素,并应用巢式RT-PCR扩增HIV-1pol区和env区基因,经DNA测序后用遗传进化系统树比对的方法,结合现场调查资料进行综合分析。[结果]该家庭中3人HIV感染毒株亚型均为CRF 07-BC。3个病例毒株的基因同源性高达99%和98%,且克隆基因差异较小,父母之间的基因克隆进化关系成立,但父子之间的进化关系明显大于母子的关系。3人与耐药相关基因突变位点分布情况基本一致,但在A71T位点上的突变率以儿子最高(100%),父亲其次(83%),母亲则未发生突变。[结论]该家庭中母亲是感染了父亲的部分尚未发生变异的病毒株,儿子则感染了父亲体内的变异株,初步提示为家庭内个人密切接触的HIV感染。

A molecular epidemiological study on HIV-1 transmission within a family

[Objective] To describe HIV-1 transmission within a family through clinical,epidemiological and molecular investigation to identify the transmission relationships among family members. [Methods] To investigate the risk factors for intrafamilial transmission of HIV-1 infection through qualitative epidemiology,to comprehensively analyze the HIV-1 pol and env gene which were amplified by nest RT-PCR,sequenced and phylogenetically analyzed and to compare with the data from clinical epidemiological survey. [Results] The subtype of HIV-1 of all three people of the family was CRF 07-BC.Phylogenetic analysis of the three people was as high as 98%-99%.The diversity of genetic clone was insignificant.The genetic relation was established among the parents' genetic clone,furthermore the son's genetic relation with the father was much higher than that with mother,and the drug resistance associated mutations of three patients were basically similar,other than A71T.The mutation rates at A71T of the son and father were 100% and 83% respectively,while no mutation happened in the mother.[Conclusion] In this family,the mother was infected by the father's part of the viruses which had not mutated,whilst the son was infected by the father's mutated virus.This study preliminarily revealed that the HIV transmission is due to intimate personal exposure among this family.