桂林市经性传播的HIV-1的流行特征和亚型分析

摘要

Objective To determine the epidemiological situation of confirmed HIV-1 infections in Guilin after 2008 who were infected by sexually transmission, and to understand the distribution of HIV-1 subtypes. Methods To make epidemiological survey on the 100 confirmed HIV-1 infections, extract HIV-1 RNA from their whole blood and amplified by RT-PCR. HIV-1 gag gene was sequenced directly from the PCR product. Results In the chosen patients, male to female ratio was 2. 125 ∶ 1. Patients aged ≥20 and ≤49 years old accounted for 54% in total, and patients aged 50 years old or older accounted for 45%. Farmers accounted for 40% and students accounted for 6%. Patients with education level of junior middle school or below accounted for 69%. The proportions which were transmitted through heterosexual and homosexual contact were 93% and 7% respectively. 61 specimens were gained in 100 specimens, then sequence analysis showed that there were 3 HIV-1 subtypes, CRF01-AE(48 samples),B (5 samples),CRF-07BC(8 samples). Conclusion The more attentions should be paid to the HIV/AIDS antibody screening in marriage and pregnancy inspection, focus on HIV/AIDS infection though sexual transmission in elderly people, and more effective ways to prevent HIV/AIDS infection for the population with poor education level should be explored. With the change of the main transmission and subtype, the more education and behavioral interven-tions should be done to prevent the spread of HIV/ AIDS.%目的：了解桂林市2008年及以后确诊的经性传播的人类免疫缺陷病毒1型( HIV-1)感染者的流行病学及亚型的分布情况。方法选取样本100例,收集流行病学资料,采集抗凝全血,提取病毒RNA,RT-PCR法行gag基因扩增,对产物进行测序和分析。结果100例样本中男女比例为2．125∶1；青壮年年龄组(20~49岁)患者为54%,>50岁年龄组患者为45%；职业为农民的患者为40%,学生为6%；初中及以下文化水平患者占69%；经异性和同性性接触途径传播的分别为93%、7%。100例样本最终成功扩增得到61例样本的 gag 基因序列, CRF01-AE 重组亚型48例, CRF07-BC重组亚型8例,B亚型5例。结论应更加重视婚检、孕检的艾滋病抗体筛查；关注老年人群经性接触途径感染艾滋病的现象；采取针对低素质人群的有效防治措施；随着主要传播途径和主要亚型的变化,迫切需要对高危人群进行宣传教育和行为干预以阻断HIV/AIDS的流行和传播。