摘要目的 了解广州市外籍HIV-l感染者病毒亚型分布特征.方法 从广州市2008-2010年报告和2015年新确诊的外籍HIV-1感染者151份血清样本中成功获得共114份pol区基因片段,测序后构建系统进化树确定亚型.结果 114名外籍HIV-1感染者中,男性占57.9％(66/114),女性占42.1％(48/114);平均年龄(35.21±9.63)岁;来自非洲地区占65.8％(75/114).HIV-1各亚型构成比居前3位的分别为CRF02 AG重组型、G亚型和C亚型,分别占30.7％(35/114)、14.9％(17/114)和12.3％(14/114).与2008-2010年相比,2015年以A1亚型(20.0％,5/25)和CRF01 AE重组型(24.0％,6/25)为主,其他亚型占比较少.男性的CRF01 AE亚型和G亚型的构成比分别为12.1％(8/66)和18.2％(12/66),均高于女性的2.1％(1/48)和10.4％(5/48);女性的A1亚型、CRF02 AG亚型和URF亚型的构成比分别为12.5％(6/48)、35.4％(17/48)和10.4％(5/48),均高于男性的3.0％(2/66)、27.3％(18/66)和6.1％(4/66).来自非洲地区的以CRF02 AG亚型(32.0％,24/75)和G亚型(17.3％,13/75)为主.来自东南亚地区的以CRF01 AE为主(50.0％,5/10).对蛋白酶抑制剂(PIs)和反转录酶抑制剂(RTIs)任意1种的耐药率为21.9％(25/114),对PIs、核苷类反转录酶抑制剂(NRTIs)和非核苷类反转录酶抑制剂(NNRTIs)的耐药率分别为12.3％(14/114)、6.1％(7/114)和7.0％(8/114).1例CRF01 AE亚型外籍感染者与本地感染者在进化树上关系密切(bootstrap=0.855).结论 广州市的外籍HIV-1感染者带来了不同于广州本地的流行亚型,增加了国外毒株本地化和耐药毒株传播的风险.

abstractsObjective To understand the characteristic of subtype distribution among foreigners who were living with HIV-1,in Guangzhou.Methods HIV-1 RNAs were extracted from 114 serum specimens in foreigners diagnosed with HIV-1 infections between 2008 and 2010,and in 2015.Partial pol gene of HIV-1 genome from these RNA samples were amplified by nested reverse transcription polymerase chain reaction (nested-PCR) with nucleotide sequenced.Subsequently,phylogenetic tree was reconstructed using the pol sequences of samples and references.Results Among all the 114 samples,57.9％ were from males and 42.1％ from females,with an average age as 35.21 years old and the standard deviation as 9.63 years.A total of 6.8％ of the samples were from Africans.The top three subtypes were identified as CRF02_AG,subtype G and subtype C,accounted for 30.7％,14.9％ and 12.3％ respectively.Compared with samples gathered from 2008 to 2010,the proportions of subtype A1 and CRF01_AE significantly increased,while the other subtypes significantly decreased in 2015 (x 2=37.570;P=0.013,99％ CI:0.010-0.016).Proportions of CRF01_AE and subtype G among males outnumbered the females but the proportions of subtype A1,CRF02_AG and URF among females appeared the other way round (x2=15.528;P=0.029,99％CI:0.024-0.033).Proportions of CRF02_AG and subtype G among HIV-1 positive Africans were larger than those from other Southeast Asian countries or areas,However,the proportion of CRF01_AE among HIV-1 positive patients from Southeast Asian countries was higher than those patients from other areas (x2=39.399;P=0.009,99％ CI:0.006-0.011).The rates of resistance to any drug of protease inhibitors (PIs),reverse transcriptase inhibitors (RTIs),as well as to PIs,NRTIs,and NNRTIs alone,were 21.9％,12.3％,6.1％ and 7.0％,respectively.One of nine CRF01_AEs from the HIV-1 positive patients were found closely clustered in those phylogenetic tree (bootstrap=0.855) samples,collected from local patients in Guangzhou.Conclusions Our findings showed that these foreign subtypes had been spread to the natives,more from the Africans than from the other areas,in Guangzhou.These types of viruses were different from the strains identified locally,suggesting that they might have been brought in by foreigners living with HIV-1,in Guangzhou.Programs related to care,support and behavioral intervention for HIV positive foreigners living in Guangzhou,should be strengthened.