摘要目的 通过调查一起家庭内HIV-1传播事件,阐明家庭成员HIV-1毒株传播关系.方法 通过流行病学调查方法,对1例HIV-1抗体筛查有反应孕产妇及其配偶和所育婴儿进行随访和检测.运用一步法逆转录-聚合酶链反应(RT-PCR)扩增HIV-1 ga基因和pol基因片段,构建系统进化树分析其进化传播关系.结果 孕产妇(EID1107M)在孕期保健期间存在HIV抗体血清阳转现象.其丈夫(EID1107F)随后确诊为HIV-1抗体阳性;其所育婴儿(EID1107I)在出生后8个月HIV-1核酸检测阳性.3个病例均感染HIV-1 CRF02_AG毒株,进化树上聚集成可靠进化簇,拓扑学结构表明“父-母-子”之间的传播关系.结论 加强婚前检查和孕期保健感染性疾病筛查,对阳性孕产妇病例实施及时有效的母婴阻断,避免传染性疾病的家庭内二代传播,提高出生人口质量.

abstractsObjective To investigate an intra-familial transmission event of human immunodeficiency virus type 1 (HIV-1) using molecular epidemiological method,and to elucidate the spreading route among the family members.Methods Epidemiological investigation,including followup and testing,was conducted for a pregnant woman who was anti-HIV screening-reactive,her husband and their newborn.Viral RNA was extracted to amplify HIV-1 gag gene and pol gene segments with onestep RT-PCR.Phylogenetic tree was conscucted to analyze the spreading route.Results The proband (EID1107M) was a pregnant woman who was found to be HIV-seropositive during pregnant care.Her husband (EID1107F) was then confirmed to be anti-HIV positive.Her newborn (EID1107I) was positive for HIV-1 nucleic acid at age of eight months.All three patients were infected with HIV-1 CRF02_AG strain.Phylogenetic tree showed that the three patients formed a subcluster with high genetic homogeneity.The topological structure indicated the transmission route was from the father to the mother,then to their child.Conclusion Contagious diseases screening should be reinforced before marriage and during pregnant care.Prevention of mother-to-child transmission should be timely and efficiently administered upon diagnosis of infection,to avoid the secondary intra-familial transmission and to improve the population quality at birth.