引用本文：孙琦,张化江,张金波，等.2023-2024年威海市HIV-1基因亚型及分子传播网络特征分析[J].预防医学论坛，2025，31（11）：807-812.10.16406/j.pmt.issn.1672-9153.2025.11.02.

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2023-2024年威海市HIV-1基因亚型及分子传播网络特征分析

孙琦¹,张化江¹,张金波¹,吕涛¹,林丹丹¹,王宁¹,石新飞¹,赵帅²

SUN Qi,ZHANG Hua-jiang,ZHANG Jin-bo,LYU Tao,LIN Dan-dan,WANG Ning,SHI Xin-fei,ZHAO Shuai

• 1:威海市疾病预防控制中心微生物检验科;2:山东省疾病预防控制中心艾滋病防制所

1.Weihai Center for Disease Control and Prevention，Jinan，Shandong 264200，China；2.Shandong Provincial Center for Disease Control and Prevention

摘要：目的 分析威海市HIV感染者/AIDS病人HIV-1基因亚型及分子传播网络特征，为艾滋病精准防控及干预提供科学依据。方法 收集2023-2024年新报告未治疗HIV感染者/AIDS病人及抗病毒治疗失败病人血样，RT-PCR和nest-PCR扩增样本pol区基因、测序和判断基因亚型，MEGA 11.0软件构建系统进化树，Cytoscape 3.10.3软件生成分子网络，多因素logistic回归分析入网率的影响因素。结果 获得pol区基因序列174条，发现12种亚型或流行重组型，主要亚型为CRF07＿BC(44.8%)、CRF01＿AE(32.8%)。在1.5%基因阈值下，形成23个分子簇，71条序列入网，其中CRF07＿BC是成簇最多的亚型，也是形成最大的簇(10个节点)的亚型。新报告未治疗患者入网率44.1%(67/152),该人群多因素logistic回归分析结果显示，年龄为40～59岁(aOR=7.764,95%CI:1.736～34.722,P=0.007)和≥60岁(aOR=33.636,95%CI:4.672～242.145,P<0.001)、初中及以下学历(aOR=4.932,95%CI:1.594～15.265,P=0.006)、家务及待业(aOR=3.208,95%CI:1.030～9.990,P=0.044)、CRF55＿01B(aOR=18.942,95%CI:2.381～150.658,P=0.005)更容易入网。治疗失败人群入网率18.2%(4/22),分子簇出现该人群的最小基因距离是0.7%。结论 威海市HIV-1流行亚型多样化，CRF07＿BC、CRF01＿AE为主要亚型，艾滋病防控的重点是中老年人、家务待业人群和学历较低人群，同时需关注治疗失败人群，避免耐药病毒进一步传播。

Abstract：Objective To analyze the HIV-1 genetic subtypes and molecular transmission network characteristics among HIV-infected individuals/AIDS patients in Weihai City, providing a scientific basis for precise prevention, control, and intervention strategies. Methods Blood samples were collected from newly diagnosed, treatment-naive HIV-infected individuals/AIDS patients and patients who experienced antiretroviral therapy(ART) failure reported between 2023 and 2024.The pol region gene was amplified via RT-PCR and nested PCR,followed by sequencing and subtype determination.A phylogenetic tree was constructed using MEGA 11.0,and molecular networks were generated using Cytoscape 3.10.3.Multivariate logistic regression was performed to analyze factors influencing network linkage. Results A total of 174 pol region gene sequences were obtained, identifying 12 subtypes or circulating recombinant forms(CRFs).The predominant subtypes were CRF07＿BC(44.8%) and CRF01＿AE(32.8%).Under a 1.5% genetic distance threshold, 23 molecular clusters were formed, with 71 sequences linked to the network.CRF07＿BC was the subtype with the highest clustering rate and formed the largest cluster(10 nodes).The network linkage rate for newly diagnosed, treatment-naive patients was 44.1%(67/152).Multivariate logistic regression analysis for this group showed that individuals aged 40-59 years(aOR=7.764,95%CI:1.736-34.722,P=0.007) and ≥60 years(aOR=33.636,95%CI:4.672-242.145,P<0.001),those with a junior high school education or below(aOR=4.932,95%CI:1.594-15.266,P=0.006),and unemployed individuals/homemakers(aOR=3.208,95%CI:1.030-9.990,P=0.044) were more likely to be linked.The linkage rate for patients with treatment failure was 18.2%(4/22),with the minimum genetic distance observed in clusters being 0.7%. Conclusion The HIV-1 epidemic in Weihai City exhibits subtype diversity, with CRF07＿BC,CRF01＿AE being the most prevalent.Key populations for HIV prevention and control are middle-aged and elderly individuals, unemployed individuals/homemakers, people with lower educational qualifications.Attention should also be paid to patients with treatment failure to prevent the further transmission of drug-resistant viruses.

关键词： 人免疫缺陷病毒;基因亚型;分子传播网络;抗病毒治疗;基因距离阈值
KeyWords:Human immunodeficiency virus(HIV);Genetic subtypes;Molecular transmission network;Antiretroviral therapy;Genetic distance threshold

基金项目：山东省医药卫生科技项目(202312061360);; 山东省重点研发计划(科技型中小企业创新能力提升工程)项目(2024TSGC0054)

Foundation:Shandong Medical and Health Science and Technology Project (202312061360);; Shandong Key R&D Program (Innovation Capacity Improvement Project for Technology-based Small and Medium Enterprises) Project (2024TSGC0054)

DOI：10.16406/j.pmt.issn.1672-9153.2025.11.02