中华皮肤科杂志 ›› 2024, Vol. 57 ›› Issue (12): 1121-1126.doi: 10.35541/cjd.20230571

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云南省2020—2021年新报告感染HIV的男男性行为者HIV-1基因型特征与合并其他性传播疾病情况分析

张单1    涂韦1    黄旭和2    谢荣慧3    况轶群4    李玉叶1   

  1. 1昆明医科大学第一附属医院皮肤科  云南省皮肤与免疫性疾病临床医学中心，昆明  650032；2广东省疾病预防控制中心消毒与病媒生物预防控制所，广州  511430；3云南省传染病医院医务科，安宁  650399；4昆明医科大学第一附属医院临床医学研究中心，昆明  650032
  • 收稿日期:2023-10-07 修回日期:2024-06-17 发布日期:2024-12-03
  • 通讯作者: 李玉叶 E-mail:yyeli2000@126.com
  • 基金资助:
    云南省科技计划（202403AC100011）；“云南省兴滇英才支持计划”专项； 云南省艾滋病防治专项资金

Analysis of HIV-1 genotype characteristics and concurrence with other sexually transmitted diseases among newly reported HIV-infected men who have sex with men in Yunnan Province, 2020 - 2021

Zhang Dan1, Tu Wei1, Huang Xuhe2, Xie Ronghui3, Kuang Yiqun4, Li Yuye1   

  1. 1Department of Dermatology, First Affiliated Hospital of Kunming Medical University, Kunming 650032, China; 2Institute of Disinfection and Vector Prevention and Control, Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China; 3Medical Department, Yunnan Provincial Hospital of Infectious Diseases, Anning 650399, Yunnan, China; 4Clinical Medical Research Center, First Affiliated Hospital of Kunming Medical University, Kunming 650032, China
  • Received:2023-10-07 Revised:2024-06-17 Published:2024-12-03
  • Contact: Li Yuye E-mail:yyeli2000@126.com
  • Supported by:
    Yunnan Science and Technology Planning Project （202403AC100011）; “Xingdian Talents” Support Project of Yunnan Province; Yunnan Province AIDS Prevention and Control Special Fund Project

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摘要： 【摘要】 目的 了解云南省新报告男男性行为者HIV-1基因型分布和耐药特征，分析HIV-1基因型与合并其他性传播疾病（简称性病）之间的相关性。方法 本文为单中心横断面研究，收集2020年9月至2021年5月云南省传染病医院79例云南省新发现感染HIV的男男性行为者，同时收集患者的血液和前段尿样本，血液样本用于检测梅毒和单纯疱疹病毒2型抗体，尿液样本用于检测淋病奈瑟球菌、沙眼衣原体和生殖支原体核酸。分离血浆提取病毒RNA，采用巢式反转录聚合酶链反应法扩增gag、env和pol区基因片段，进行基因分型和耐药分析。采用χ2检验分析组间差异，使用logistic回归分析HIV-1基因型与性病共感染之间的相关性。结果 72例样本成功获得基因分型，共鉴定出5种基因型，依次为CRF07_BC（43.06%，31/72）、CRF01_AE（33.33%，24/72）、URF（18.06%，13/72）、CRF55_01B（2.78%，2/72）和CRF68_01B（2.78%，2/72）。13例URF分为3种重组模式，分别为11例CRF01_AE/CRF07_BC、1例CRF08_BC/CRF07_BC和1例B/CRF07_BC。对36例pol序列进行耐药分析，耐药率为5.56%（2/36）。合并其他性病发生率为40.28%（29/72），依次是梅毒20.83%（15/72）、单纯疱疹病毒2型感染16.67%（12/72）、生殖支原体感染11.11%（8/72）、淋病5.56%（4/72）和沙眼衣原体感染2.78%（2/72），合并多重性病占12.50%（9/72）。Logistic回归分析显示，各HIV-1基因型与不同性病合并感染之间无明显相关性（均P > 0.05）。结论 云南省男男性行为者HIV-1基因型复杂，耐药株呈中度流行，HIV感染者常合并其他性病，需密切关注HIV-1基因型变化情况，加强HIV感染者性病的联合筛查和治疗。

关键词: HIV, 同性恋, 男性, 基因型, 抗药性, 病毒, 性传播疾病, 共感染

Abstract: 【Abstract】 Objective To investigate the distribution of HIV-1 genotypes and drug resistance characteristics among newly reported HIV-infected men who have sex with men in Yunnan Province, and to analyze the correlation between HIV-1 genotypes and concurrence with other sexually transmitted diseases （STDs）. Methods A single-center cross-sectional study was conducted. A total of 79 newly reported HIV-infected men who have sex with men were collected from the Yunnan Provincial Hospital of Infectious Diseases from September 2020 to May 2021. Meanwhile, their blood and initial-stream urine samples were collected. Antibodies against Treponema pallidum or herpes simplex virus type 2 were detected in blood samples, while nucleic acid amplification tests were performed for the detection of Neisseria gonorrhoeae, Chlamydia trachomatis, and Mycoplasma genitalium in urine samples. Viral RNA was extracted from plasma samples, and the gag, env, and pol gene fragments were amplified by nested reverse transcription polymerase chain reaction for genotyping and drug resistance analysis. Differences between groups were analyzed using the chi-square test, and correlations between HIV-1 genotypes and concurrence with STDs were analyzed using logistic regression. Results Totally, 72 samples were successfully genotyped, and 5 genotypes were identified, including CRF07_BC （43.06%, 31/72）, CRF01_AE （33.33%, 24/72）, URF （18.06%, 13/72）, CRF55_01B （2.78%, 2/72）, and CRF68_01B （2.78%, 2/72）. The 13 cases of URF were classified into 3 recombination patterns, including 11 cases of CRF01_AE/CRF07_BC, 1 case of CRF08_BC/CRF07_BC, and 1 case of B/CRF07_BC. Drug resistance analysis was conducted for 36 cases according to the pol sequences, and the HIV drug resistance rate was 5.56% （2/36）. The rate of concurrence with other STDs was 40.28% （29/72）, and HIV infection mostly coexisted with syphilis （20.83%, 15/72）, followed by herpes simplex virus type 2 infection（16.67%, 15/72）, Mycoplasma genitalium infection （11.11%, 8/72）, gonorrhea （5.56%, 4/72） and Chlamydia trachomatis infection （2.78%, 2/72）. The rate of concurrence with two or more STDs was 12.50% （9/72）. Logistic regression analysis showed that there was no significant correlation between HIV-1 genotypes and concurrence with different STDs （all P < 0.05）. Conclusions The HIV-1 genotypes among men who have sex with men in Yunnan Province were complex, the drug resistance in HIV strains had reached a moderately epidemic level, and HIV-infected patients were often accompanied by other STDs. Thus, it is necessary to pay close attention to the change of HIV-1 genotypes and simultaneous screening and treatment of STDs in HIV-infected patients.

Key words: HIV, Homosexuality, male, Genotype, Drug resistance, viral, Sexually transmitted diseases, Coinfection

引用本文

张单 涂韦 黄旭和 谢荣慧 况轶群 李玉叶. 云南省2020—2021年新报告感染HIV的男男性行为者HIV-1基因型特征与合并其他性传播疾病情况分析[J]. 中华皮肤科杂志, 2024,57(12):1121-1126. doi:10.35541/cjd.20230571

Zhang Dan, Tu Wei, Huang Xuhe, Xie Ronghui, Kuang Yiqun, Li Yuye. Analysis of HIV-1 genotype characteristics and concurrence with other sexually transmitted diseases among newly reported HIV-infected men who have sex with men in Yunnan Province, 2020 - 2021[J]. Chinese Journal of Dermatology, 2024, 57(12): 1121-1126.doi:10.35541/cjd.20230571