摘要
目的:分析广西崇左市扶绥县艾滋病病毒(HIV)感染者的分子传播网络特征,并确定造成分子网络聚簇传播和高风险传播的危险因素.方法:采集崇左市扶绥县2005-2021年确诊的HIV/艾滋病(AIDS)患者血样.通过扩增HIV-1 po1区序列比对分析,构建分子传播网络.运用二元logistic回归分析入网和高危传播的影响因素.结果:本研究共获得扶绥县349条HIV-1 pol区序列,6 种亚型,分别为 CRF01_AE 亚型(49.86％)、CRF07_BC 亚型(32.38％)、CRF08_BC 亚型(14.33％)、CRF55_01B亚型(1.14％)、C亚型(0.29％)、独特重组型(URF)(2.00％).192条(55.01％)序列进入分子传播网络,形成31个簇、192个节点和 736 条边.年龄＞50 岁(aOR=1.861,95％CI:1.009～3.433)、感染 CRF07_BC 亚型毒株(aOR=4.386,95％CI:2.533～7.594)、文化程度为小学及以下(aOR=1.709,95％CI:1.070～2.729)、有非婚商业异性性接触史(aOR=1.682,95％CI:1.027～2.753),配偶或固定性伴阳性(aOR=2.428,95％CI:1.181～4.995)的患者更容易进入传播网络聚簇传播.年龄＞50岁(aOR=1.861,95％CI:1.009～3.433),感染 CRF07 BC 亚型(aOR=4.386,95％CI:2.533～7.594),文化程度为小学及以下(aOR=1.699,95％CI:1.004～2.874)的患者更容易成为传播网络中的高连接者.结论:广西崇左市扶绥县AIDS传播的关键人群是年龄＞50岁且文化程度为小学及以下的中老年人群,应针对重点人群的在分子网络中的传播聚簇特点进行溯源调查,并实施精准干预,减少二代传播.
Abstract
Objective:To analyze the molecular transmission network characteristics of human immunodeficien-cy virus(HIV)-infected individuals in Fusui County,Chongzuo City,Guangxi,and to explore the risk factors con-tributing to network cluster and high-risk transmission.Methods:Blood samples were collected from HIV/AIDS patients diagnosed in Fusui County between 2005 and 2021.A molecular transmission network was constructed through comparative sequence analysis of amplified HIV-1 pol sequences.Binary logistic regression was used to analyze factors influencing entry into the molecular network and high-risk transmission.Results:In this study,a total of 349 HIV-1 pol sequences were analyzed,including 6 strain subtypes from Fusui County:CRF01_AE sub-type(49.86％),CRF07_BC subtype(32.38％),CRF08_BC subtype(14.33％),CRF55_01B subtype(1.14％),C subtype(0.29％),and unique recombinant form(URF)(2.00％).Among the sequences,192(55.01％)sequenc-es entered the molecular transmission network,forming 31 clusters,192 nodes,and 736 edges.Individuals aged over 50 years(aOR=1.861,95％CI:1.009-3.433),infected with the CRF07_BC subtype strain(aOR=4.386,95％CI:2.533-7.594),with education level of primary school or below(aOR=1.709,95％CI.1.070-2.729),with a his-tory of non-marital commercial heterosexual contact(aOR=1.682,95％CI:1.027-2.753),and having a positive spouse/regular sexual partner(aOR=2.428,95％CI:1.181-4.995),were more likely to enter the transmission net-work for cluster transmission.Furthermore,individuals aged over 50 years(aOR=1.861,95％CI:1.009-3.433),infected with CRF07_BC(aOR=4.386,95％CI:2.533-7.594),and with education level of primary school or be-low(aOR=1.699,95％CI:1.004-2.874),were more likely to be high linkage transmission.Conclusion:The key population for AIDS transmission in Fusui County,Chongzuo City,Guangxi,is older adults aged over 50 years with a primary school education or below.It is important to conduct source tracing investigations based on the transmission clustering characteristics of key populations in the molecular network and implement targeted inter-ventions to reduce secondary transmission.
基金项目
国家自然科学基金资助项目(82060610)
广西自然科学基金资助项目(2022GXNSFAA026365)
维普
万方数据