HIV-1/HCV合并感染者中HCV基因亚型流行情况调查

摘要

目的 了解中国部分地区HIV-1和HCV合并感染人群中HCV基因亚型的流行、分布及其与HIV-1感染疾病进展的关系.方法 对186份获自河南、云南、新疆、吉林和辽宁省HIV-1/HCV合并感染人群标本(HCV病毒载量>1000 cop/ml),用反转录巢式聚合酶链反应方法扩增血浆HCV核心基因区并进行基因亚型分型,同时检测HIV-1和HCV载量以及CD4+T细胞计数.结果 (1)HCV不同基因亚型比例分别为1a(1.7%)、1b(39.9%)、2a(17.9%)、3a(10.4%)、3b(15.6%)、6a(1.2%)、6n(6.4%)和6型未鉴定亚型(7.5%).HCV 2a和1b主要流行于河南省既往有偿献血浆人员中;3a和3b亚型主要流行于新疆和云南静脉注射吸毒者(IDU)中;HCV6型主要流行于云南吸毒人员中.(2)1b亚型的HCVRNA水平显著高于非1b亚型,但在HIV-1载量和CD4+T细胞数方面差异无统计学意义.2a亚型的HIV-1 RNA和HCV RNA水平显著低于非2a亚型.结论 HIV-1/HCV合并感染人群中HCV基因亚型的流行和分布与流行地区和感染途径有关.新的HCV6型亚型病毒株已经在合并感染的IDU人群中流行.尚未发现HCV基因哑型与HIV感染疾病进展之间的关系.%Objective To better understand the prevalence and geographic distribution of genotypes/subtypes on HCV and the relationship between HCV genotypes/subtypes and HIV infection disease progression in the HIV-1/HCV co-infected individuals living in high HIV-1 prevalent areas in China. Methods 186 plasma samples were collected from HIV-1 seropositive individuals infected through paid blood donors (PBD), injecting drug users (IDUs) or sexual contact, living in most severely affected provinces, Henan, Yunnan, Xinjiang, Jilin and Liaoning provinces. Samples with HCV viral load >1000 cop/ml were amplified by RT-nested PCR, sequenced and phylogenetically analyzed for genotyping/subtyping of HCV. HIV-1, HCV viral loads and CD4 T lymphocytes were measured for all subjects. Results (1) HCV were identified as 1 a (1.7%), 1 b (39.9%), 2a (17.9%), 3a (10.4%), 3b (15.6%), 6a (1.2%), 6n (6.4%), and a newly unclassified subtype (7.5%). HCV 2a and lb subtypes predominated in PBD in Henan, 3a and 3b in IDUs in Xinjiang and Yunnan, and 6 genotype/subtypes in IDU in Yunnan. (2) There were no significant differences in CD4 T cell counts among the different HCV subtypes. (3) The viral load of HCV RNA in lb subtype was higher than that of non-1b subtype, however, no significant differences in HIV-1 viral loads and CD4 T cell counts were found between Ib and non-1b subtype. Both HIV and HCV viral loads were lower in 2a than non-2a subtype. Conclusion The prevalence of HCV genotype/subtype in HIV-1/FICV co-infected individuals was associated with geographic areas and transmission routes. HCV subtypes had no direct correlation with HIV infection disease progression.