CAJ | 학술논문

目的：了解 HIV-1 CRF01 AE 毒株在我国的分子流行特征。方法计算机检索相关数据库并结合文献追溯的方法提取数据，按地区和研究人群分组进行 Meta 分析，计算 HIV-1 CRF01 AE感染者占不同高危人群的比例。从美国洛斯阿拉莫斯国家实验室 HIV 基因数据库（Los Alamos database）中下载中国地区的 CRF01 AE pol 区基因序列，利用 FastTree2．1构建系统进化树进行成簇分析。根据 BEAST V 1．6．2和 Spread 计算贝叶斯因子分析空间地理传播关联。结果 HIV-1 CRF01 AE 毒株在我国6个地区的 MSM 人群中所占比例均＞45．0％；在东部、北部、西南和中南地区的异性性行为人群中所占比例均＞30．0％；在中南地区的静脉药瘾人群中所占比例最高，为57．3％（95％CI ：35．1％～79．6％）；而输血传播人群仅在中南地区占有较低的比例，为10．6％（95％CI ：6．2％～14．9％）。系统进化分析表明，该毒株在我国形成7个独立的传播簇，其中簇1、3、5主要流行于异性性行为感染人群中，簇2及簇6主要流行于 MSM 人群中，簇4主要流行于性行为感染人群中。簇1～5均在西南地区流行，中南地区主要流行簇7和簇1，北部地区主要流行簇2和簇6，东部地区主要流行簇2和簇4，东北地区主要流行簇6。贝叶斯因子分析结果显示，该毒株在我国东部、中南部、西南部、北部及东北部的省份之间传播关系错综复杂。结论 CRF01 AE 毒株活跃在我国各个地区的多个高危人群中，不同地区之间的传播关联错综复杂。
목적：료해 HIV-1 CRF01 AE 독주재아국적분자류행특정。방법계산궤검색상관수거고병결합문헌추소적방법제취수거，안지구화연구인군분조진행 Meta 분석，계산 HIV-1 CRF01 AE감염자점불동고위인군적비례。종미국락사아랍막사국가실험실 HIV 기인수거고（Los Alamos database）중하재중국지구적 CRF01 AE pol 구기인서렬，이용 FastTree2．1구건계통진화수진행성족분석。근거 BEAST V 1．6．2화 Spread 계산패협사인자분석공간지리전파관련。결과 HIV-1 CRF01 AE 독주재아국6개지구적 MSM 인군중소점비례균＞45．0％；재동부、북부、서남화중남지구적이성성행위인군중소점비례균＞30．0％；재중남지구적정맥약은인군중소점비례최고，위57．3％（95％CI ：35．1％～79．6％）；이수혈전파인군부재중남지구점유교저적비례，위10．6％（95％CI ：6．2％～14．9％）。계통진화분석표명，해독주재아국형성7개독립적전파족，기중족1、3、5주요류행우이성성행위감염인군중，족2급족6주요류행우 MSM 인군중，족4주요류행우성행위감염인군중。족1～5균재서남지구류행，중남지구주요류행족7화족1，북부지구주요류행족2화족6，동부지구주요류행족2화족4，동북지구주요류행족6。패협사인자분석결과현시，해독주재아국동부、중남부、서남부、북부급동북부적성빈지간전파관계착종복잡。결론 CRF01 AE 독주활약재아국각개지구적다개고위인군중，불동지구지간적전파관련착종복잡。
Objective To understand the molecular epidemiological characterization of human immunodeficiency virus (HIV)-1 CRF01 AE strains in China.Methods Data were extracted by a systematic search in the databases combined with literature review.Data were then grouped according to the sites and risk groups for a Meta-analysis.Sequences of CRF01 AE pol genes from China were downloaded from Los Alamos database to build phylogenetic trees by means of FastTree2.1 .The Bayes factor test was calculated by BEAST V1 .6.2 package and Spread to explore spatial transmission links. Results Meta-analysis demonstrated that CRF01 AE strains accounted for more than 45 .0% of all subtypes among men who have sex with men (MSM)in six areas of China.Among heterosexuals in eastern,northern,southwestern and south-central China,the proportions of CRF01 AE strains exceeded 30.0%. The strains were also prevalent among intravenous drug users in south-central regions, accounting for 57.3% (95 %CI :35 .1 %-79.6%),and were only detected among blood donors in south-central China (10.6%,95 %CI :6.2% - 14.9%).Seven distinct phylogenetic clusters of CRF01 AE strains which were transmitted independently were identified.Clusters 1 ,3 and 5 were prevalent among heterosexuals,while clusters 2 and 6 were found primarily among MSM,and clusters 4 was detected chiefly among sexual contact people.Geographically,clusters 1,2,3,4 and 5 were prevalent in southwestern areas. Clusters 1 and 7 were circulating in south-central areas.Clusters 2 and 6 were prevalent in northern areas,while clusters 2 and 4 were dominant in eastern regions and cluster 6 was prevalent in northeastern China.The Bayes factor test reveals the complexity of transmission links among eastern,south-central,southwestern, northern,and northeastern provinces.Conclusion CRF01 AE strains are prevalent in most high risk groups in multiple regions of China and the transmission between different regions is complicated.