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目的 研究湖南省张家界市永定区老年HIV-1感染者间B亚型毒株的传播关系,并探索一种溯源方法.方法 选取43例张家界永定区新发老年HIV-1感染者作为研究对象,取首次检测CD4+T淋巴细胞血浆样本,用In-house法扩增HIV-1的pol区序列,测序后,通过HIV进化树结合流行病学结果对个体间病毒传播关系进行相关性分析.结果 共获得42条有效序列.B亚型占80.95％(34/42),分为8个聚集簇,簇内毒株的遗传距离明显小于34条B亚型的平均遗传距离(0.058 3).聚集簇内感染者有相同高危行为史,且发生高危行为的地点呈现明显关联灶性分布.提示该地老年人群中HIV-1感染在地理位置和行为学方面具有同源性.结论 张家界市永定区老年人HIV-1间存在地理位置和行为关联性的灶性分布.研究方法可为实施精确疫情定位和干预措施提供依据.

Objective To investigate the characteristics of transmission correlativity regarding subtype B among elderly HIV-1 infected individuals in Yongding district,Zhangjiajie city,Hunan province and to explore a method on its traceability.Methods A total of 43 newly diagnosed elderly HIV-1 Infected individuals in Yongding district were enrolled in this study.Pol area genes were amplified and sequenced by ‘In house’ method.Methods used to analyze the relationship related to HIV individuals transmission would include Bayesian phylogenetic tree and other epidemiological ones.Results A total of 42 valid sequences were successfully obtained,with predominant strain as subtype B (80.95％,34/42).All the 42 sequences were gathered into eight clusters.In each cluster,the genetic distance was significantly shorter than the average from the 34 subtype B strains (0.058 3).The HIV-1 infected individuals in one cluster had the same high-risk behaviors and the significantly patchy distributions were identified at the sites where the high-risk behaviors existed.Our results indicated that the local elderly HIV-infected individuals had high level of homology between geographical position and related behaviors.Conclusions The patchy distribution between geographical position and behavior was associated among the elderly HIV-1 infected individuals.Guidance related to epidemic precise positioning and effective interventions was provided through the findings of this study.