目的：了解新疆部分地区 HIV-1／HCV 合并感染者的 HCV 基因变化规律。方法采用ELISA 法检测212例 HIV-1感染者的抗-HCV，柱式核酸纯化试剂盒提取血浆中病毒 RNA，以PrimeScriptTM Ⅱ1st Strand cDNA Synthesis 试剂盒进行反转录，并扩增 HCV 5′端非编码区（5′UTR）基因，将所获序列与 HCV 国际标准株进行比较，确定 HCV 基因型。计算4次采样毒株序列变异的基因离散率并建立进化树。结果212例 HIV-1感染者中抗-HCV 阳性157例，155例为静脉药瘾者，2例为异性性接触者。131例成功扩增 HCV 5′UTR 基因并进行了基因分型，结果3a 基因型占30．53％（40／131）、3b 基因型占17．56％（23／131）、1a 基因型占8．40％（11／131）、1b 基因型占42．75％（56／131）、6a 基因型占0．76％（1／131）。完成2年随访的38例感染者整体基因同源性为87．5％～99．3％，不同亚型的同源性有差异，同一样本的4次序列的同源性为99．3％～100．0％，变异率为0～0．7％。随着采样时间的推移，组内基因离散率以及与首次采样序列的组间基因离散率呈现依次增大的趋势。新疆地区HIV-1感染者体内的 HCV 的5′UTR 基因平均进化速率为1．62×10－3替换／（位点·年）（95％CI ：1．52×10－3～5．38×10－3）。同一研究对象的4次序列之间相似度和同源度最高。结论新疆地区 HIV／HCV 合并感染率较高，静脉药瘾者高于异性性接触者。HCV 以1b 亚型为优势流行毒株。%Objective To investigate the genetic dynamics of hepatitis C virus (HCV)5′untranslated regions (UTR)gene in human immunodeficiency virus (HIV-1)/HCV co-infected patients in Xinjiang.Methods Anti-HCV was tested using enzyme linked immunosorbent assay in 212 HIV-1 infected patients in Xinjiang. RNA was extracted from HIV-1/HCV co-infected samples.Then HCV 5′UTR gene was amplified after reverse transcription using PrimeScriptTMⅡ 1st Strand cDNA Synthesis kit.The sequences were then compared with HCV international standard strains to determine the HCV gene types.The gene distance of 4 sampling virus strains was calculated and the phylogenetic analysis was performed to establish the cladogram.Results One hundred and fifty-seven among the 212 HIV-infected patients were HCV antibody positive.Of them,2 patients were infected through heterosexual transmission and the remaining 155 patients were injection drug users (IDU). HCV 5′UTR was amlipicated and geno-typed successfully in 131 samples.Five HCV genotypes were identified, including 3a (40/131,30.53%),3b (23/131,17.56%),1a (11/131,8.40%),1b (56/131,42.75%),and 6a (1/131,0.76%).The general homology was 87.5%-99.3% in 38 patients,and there were differences in homology in different subtypes.The homology of the 4 sampling sequences from the same sample was 99.3%-100.0%,with the variation of 0 -0.7%.The intragroup gene deviation and deviation with the first sample tended to increase with time.The mean evolutionary rate of HCV 5′UTR in HIV-1 infected patients in Xinjiang was 1.62 × 10 -3 (95%CI :1.52 × 10 -3 -5.38 × 10 -3 ).The similarity and homology of several sequences obtained from the one participant were the highest.Conclusions The prevalence of HCV co-infection among HIV-1 infected patients in Xinjiang is high,especially among IDU.Subtype 1b of HCV is prevalent strain.
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