摘要目的 观察HIV-1感染者在原发感染早期的不同阶段,体内病毒对CCR5和CXCR4辅助受体利用特点及演变情况.方法 以高危人群前瞻性队列研究的方式随访发现12例HIV-1原发感染者,分别收集感染最早期和病毒载量稳定期(病毒调定点)的血浆,提取病毒RNA,反转录(RT)-PCR,套式PCR扩增env gp160基因,连接到TA克隆载体,测序分析,以Geno2pheno、PSSMx4r5PSSMsinsi、SVM、Charge Rule 5种在线生物信息学工具预测病毒株CCB5和CXCR4辅助受体利用情况.结果 12例原发感染者感染早期病毒利用CCR5嗜性者有11例,利用CXCR4辅助受体1例;1例在随访10个月时检出辅助受体的转换;不同基因型预测方法的结果一致性88.3%.结论 HIV-1原发感染者早期病毒主要利用CCR5受体,也有利用CXCR4受体,原发感染者在感染1年内可能发生辅助受体的转换;以基因型预测CCB3或CXCR4辅助受体宜选用多种不同的分析方法.

abstractsObjective To evaluate the coreceptor usage characters and evolution of human immunodeficiency virus-1 ( HIV-1 ) primary infection. Methods A total of 12 HIV-1 primary infection cases were recruited from a high-risk population for this prospective cohort trial. The blood samples were collected at the earliest time after infection and after a viral setpoint respectively. RNA was extracted from plasma. The env genes were amplified through reverse transcription-PCR (RT-PCR) and nested PCR. And the env fragments were ligated to T vector and then sequenced. The pattern of coreceptor usage was predicted with five different online tools. Results Among them, 11 were predicted as CCR5 virus transmission and 1 as CXCR4 virus transmission. The viruses in 1 case were detected as a switch of coreceptor usage from CCR5 to CXCR4. The consistency of five different prediction rules was 88. 3%. Conclusion Although the CCR5 usage virus is predominant in primary infection through sexual transmission, CXCR4 usage virus can also be detected. A switch of coreceptor usage may happen within the first year post-infection. Adopting multiple rules may improve the efficiency and validity for the prediction of coreceptor usage based on genotypes.