江苏省艾滋病病毒感染的分子流行病学研究

目的 了解江苏省不同人群中艾滋病病毒(HIV)各亚型毒株的流行情况和传播规律。方法 收集HIV感染者及患者的流行病学资料；无菌采集HIV感染者或艾滋病(AIDS)患者抗凝全血标本5ml，提取前病毒DNA，用巢式聚合酶链反应(nested—PCR)扩增膜蛋白基因的C2～V3区，进行序列测定，鉴定病毒亚型。用威斯康星GCG软件进行共享序列、基因离散率的计算和毒株的聚类分析。结果 截止2001年底，江苏省已发现HIV-1中的A、B、C、D、E五种亚型和一个B亚型变种(B^ )流行，C(占40．48％)和B^ (38．10％)亚型为主要流行株；静脉吸毒感染人群中86．67％为C亚型，采供血和受血感染人群中91．67％为B^ 亚型，在性途径传播人群中所有六种亚型均有，且分布较为均一。结论有偿献血人群中B^ 亚型毒株由邻省传人，吸毒人群中C亚型毒株的传人主要与新疆籍流动人口的介入有关；多种亚型的并存说明江苏省存在着适宜AIDS流行的各种危险因素；提示今后在药物治疗、疫苗研制以及其他防制工作上将面临更大的困难。

A molecular epidemiological study on the human immunodeficiency virus infection in Jiangsu province

OBJECTIVE: To identify subtypes of human immunodeficiency virus 1 (HIV-1) strains and their distribution, infection sources, and the trends of HIV infection in Jiangsu province. METHODS: Anticongulated bloods from 46 infected persons were collected to separate previrus DNA. HIV-1 env genes were then amplified by nested-PCR and sequenced for their C2-V3 region so as to identify subtypes. The analysis of consensus sequence, genetic distance and phylogenetic tree were conducted with GCG software. RESULTS: By the end of 2001, there had been six subtypes of HIV-1 strains identified in Jiangsu province: A, B, B', C, D and E. The predominant subtypes were C (accounting for 40.48%) and B' (accounting for 38.10%). Subtype C accounted for 86.67% among injecting DUs while subtype B' accounted for 91.67% among commercial blood donors and receivers. CONCLUSION: Subtype B'among commercial blood donors was brought to Jiangsu from neighboring provinces. The outbreak of HIV-1 infection among local DUs was caused by subtype C from Xinjiang province. Findings from HIV/AIDS molecular epidemiologic study suggest that it is challenging for Jiangsu to treat patients, apply vaccine, prevent and control AIDS in the future.