Dominance of HIV-1 subtype CRF01_AE in sexually acquired cases leads to a new epidemic in Yunnan province of China.
Dominance of HIV-1 subtype CRF01_AE in sexually acquired cases leads to a new epidemic in Yunnan province of China.
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DOI：
10.1371/journal.pmed.0030443
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发表时间：
2006-11
期刊：
影响因子：
15.8
通讯作者：
Chen Z
中科院分区：
文献类型：
--
作者：
Zhang Y;Lu L;Ba L;Liu L;Yang L;Jia M;Wang H;Fang Q;Shi Y;Yan W;Chang G;Zhang L;Ho DD;Chen Z
自1989年首次在注射吸毒者中流行以来，云南省一直是中国感染人类免疫缺陷病毒1型（HIV-1）人数最多的省份。然而，云南省HIV-1的分子流行病学特征尚未完全确定。我们使用免疫测定法，在1989年至2004年期间，在云南确定了103，015例HIV-1感染者。我们研究了来自云南16个地州的321名患者，他们来自4个危险群体、11个民族和10个职业。通过分析p17（gag基因的一部分）的序列，我们确定了三种主要的循环亚型：C/CRF07_BC/CRF08_BC（53%）、CRF01_AE（40.5%）和B（6.5%）。对于已知危险因素的患者，90.9%的注射吸毒者感染了C/CRF07_BC/CRF08_BC病毒，而85.4%的CRF01_AE感染是通过性传播获得的。CRF01_AE病毒在傣族人群中没有明显的分离。在地理上，C/CRF07_BC/CRF08_BC在全省都有发现，而CRF01_AE主要局限于与缅甸接壤的省份。此外，基于其逆转录酶基因的表征，发现C/CRF07_BC/CRF08_BC病毒由一组病毒组成，包括C、CRF08_BC、CRF07_BC和新的BC重组体。这是云南省HIV-1分子流行病学研究的首次报道。虽然C/CRF07_BC/CRF08_BC和CRF01_AE是共显性的，但许多性传播的CRF01_AE病例的发现是新的，并表明该亚型可能导致中国普通人群中的新流行。我们讨论了我们的研究结果对理解HIV-1大流行的演变和疫苗开发的影响。这是对云南省流行的HIV毒株和亚型的分子流行病学研究，云南省是中国HIV感染者人数最多的省份。1989年，中国西南部的云南省发现了首例人类免疫缺陷病毒（HIV）病例。该地区与缅甸、老挝和越南接壤，是非法毒品进入中国的主要入口。该地区最初的艾滋病毒爆发是在注射毒品者中，但艾滋病毒开始影响云南省的其他人群，并在中国各地变得越来越普遍。目前对中国不同类型的艾滋病毒以及哪些人群最有可能被感染还知之甚少。这方面的知识很重要，因为它可以帮助人们了解这一流行病是如何开始的，以及今后可能如何蔓延，还因为它有助于直接开展艾滋病毒教育和预防工作。这对今后设计适当的艾滋病毒疫苗也是必要的。云南省是中国艾滋病毒感染率最高的省份。它是新的HIV病毒类型进入中国的重要入口，在中国其他地区的患者中发现的一些HIV类型似乎是从云南传播的。来自美国和中国的一组研究人员希望研究感染云南省人的不同类型的艾滋病毒，并研究这些类型在中国艾滋病毒流行过程中是如何演变的。他们的重点是人类免疫缺陷病毒1型（HIV-1），这是全世界最常见的HIV病毒形式，也是最具传染性的。HIV-1至少有九种不同的亚型，而且这种病毒还在继续进化，形成新的亚型。他们收集了321名HIV感染者的血液样本，这些人代表了云南人口的广泛代表性（来自该省所有地理区域的人，11个民族人口，不同职业等）。并分析了这些血液样本中发现的病毒的遗传信息。由于HIV进化非常迅速，不同病毒亚型之间的遗传信息不同，因此研究人员可以分辨出哪些亚型感染了哪些人群。研究人员确定了三种不同的HIV-1亚型："B"（约6.5%的样本），一组"C"变体（53%的样本中有C/CRF07_BC/CRF08_BC）和CRF01_AE（40.5%）。CRF01_AE亚型以前在中国人群中没有报告过如此高的水平，被认为通过性接触（而不是污染的针头）感染艾滋病毒的人更有可能感染这种特定的亚型。结果表明，云南省HIV感染者的型别呈现出动态的、不断演变的模式，在不同的人群中呈分离状态。性传播似乎呈上升趋势，表明这一流行病可能从吸毒者等高危群体迅速蔓延到一般人群。因此，迫切需要在一般民众中开展艾滋病毒/后天免疫机能丧失综合症（艾滋病）的教育和预防工作。随着各种亚型的传播，云南省艾滋病毒流行的一些发展也可能与中国其他地区相似。该研究的结果也对未来的艾滋病毒疫苗开发具有影响。考虑到亚型的范围，有必要开发可以保护所有流行亚型的疫苗，或者有几种疫苗的混合物，每种疫苗都可以保护其中的一些。请通过www.example.com上的本摘要在线版本访问这些网站。来自国际艾滋病慈善机构AVERT关于中国艾滋病病毒亚型和艾滋病病毒的信息联合国艾滋病规划署关于亚洲艾滋病的信息中国艾滋病网络-致力于中国艾滋病研究的慈善机构
Dating back to the first epidemic among injection drug users in 1989, the Yunnan province has had the highest number of human immunodeficiency virus type 1 (HIV-1) infections in China. However, the molecular epidemiology of HIV-1 in Yunnan has not been fully characterized. Using immunoassays, we identified 103,015 accumulated cases of HIV-1 infections in Yunnan between 1989 and 2004. We studied 321 patients representing Yunnan's 16 prefectures from four risk groups, 11 ethnic populations, and ten occupations. We identified three major circulating subtypes: C/CRF07_BC/CRF08_BC (53%), CRF01_AE (40.5%), and B (6.5%) by analyzing the sequence of p17, which is part of the gag gene. For patients with known risk factors, 90.9% of injection drug users had C/CRF07_BC/CRF08_BC viruses, whereas 85.4% of CRF01_AE infections were acquired through sexual transmission. No distinct segregation of CRF01_AE viruses was found among the Dai ethnic group. Geographically, C/CRF07_BC/CRF08_BC was found throughout the province, while CRF01_AE was largely confined to the prefectures bordering Myanmar. Furthermore, C/CRF07_BC/CRF08_BC viruses were found to consist of a group of viruses, including C, CRF08_BC, CRF07_BC, and new BC recombinants, based on the characterization of their reverse transcriptase genes. This is the first report of a province-wide HIV-1 molecular epidemiological study in Yunnan. While C/CRF07_BC/CRF08_BC and CRF01_AE are codominant, the discovery of many sexually transmitted CRF01_AE cases is new and suggests that this subtype may lead to a new epidemic in the general Chinese population. We discuss implications of our results for understanding the evolution of the HIV-1 pandemic and for vaccine development. This is a molecular epidemiology study of circulating HIV strains and subtypes in Yunnan province, which has China's largest number of HIV-infected individuals. The first human immunodeficiency virus (HIV) cases in China were seen in 1989 in Yunnan, a region of south-western China. This area borders Myanmar, Laos, and Vietnam, and is a major entry point for illegal drugs into China. The initial HIV outbreak in this area was in injecting drug users, but HIV is beginning to affect other groups of people in the Yunnan province and is becoming more common across China. There is still not much known about the different types of HIV virus in China and which parts of the population are most likely to be infected. This knowledge is important because it can help people to understand how the epidemic started and how it is likely to spread in the future, and because it helps direct efforts for HIV education and prevention. It is also necessary for the future design of appropriate HIV vaccines. The Yunnan province has the highest rate of HIV-infected individuals in China. It is an important entry point of new HIV virus types into China, and some of the HIV types found in patients in other parts of China appear to have spread from Yunnan. A group of researchers from the United States and China wanted to look at the different types of HIV virus that were infecting people in the Yunnan province and to work out how these types had evolved over the course of the HIV epidemic in China. They focused on human immunodeficiency virus type 1 (HIV-1), the most common form of HIV virus worldwide and also the most infectious. There are at least nine distinct subtypes of HIV-1, and the virus continues to evolve and to form new subtypes. They collected blood samples from 321 HIV-infected individuals who represented a broad cross-section of the population of Yunnan (people from all geographic parts of the province, 11 ethnic populations, different occupations, etc.) and analyzed the genetic information of the viruses found in these blood samples. Because HIV evolves very rapidly, the genetic information differs between different virus subtypes, and the researchers could therefore tell which subtypes were infecting which subsets of the population. The researchers identified three distinct subtypes of HIV-1: “B” (in about 6.5% of the samples), a group of “C” variants (C/CRF07_BC/CRF08_BC in 53% of the samples), and CRF01_AE (in 40.5%). The CRF01_AE subtype had not previously been reported at such high levels in the Chinese population, and people who were thought to have been infected with HIV through sexual contact (as opposed to contaminated needles) were more likely to be infected with that particular subtype. The results show a dynamic and evolving pattern of HIV types in the Yunnan province, segregating among different parts of the population. Sexual transmission appears to be on the rise, suggesting that the epidemic could spread rapidly from high-risk groups such as drug users to the general population. HIV/acquired immunodeficiency syndrome (AIDS) education and prevention efforts in the general population are therefore urgently needed. It is also likely that some of the developments of the HIV epidemic in the Yunnan province will be similar in other parts of China as the various subtypes spread. The results of the study also have implications for future HIV vaccine development. Given the range of subtypes, it will be necessary either to develop vaccines that can protect against all the circulating subtypes, or to have a cocktail of several vaccines that each protects against some of them. Please access these Web sites via the online version of this summary at http://dx.doi.org/10.1371/journal.pmed.0030443. Information from AVERT, an international AIDS charity on HIV subtypes and HIV in China The UNAIDS on AIDS in Asia The China AIDS Network—a charity devoted to AIDS research in China
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影响因子：
4.9
作者：
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通讯作者：
Yu, YH
影响因子：
13.8
作者：
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通讯作者：
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影响因子：
1.5
作者：
Sánchez-Merino, V;Herrero, CC;López-Galíndez, C
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影响因子：
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作者：
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通讯作者：
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DOI：
10.1080/09540120500100676
发表时间：
2005-11-01
影响因子：
1.7
作者：
Hesketh, T;Zhang, J;Qiang, DJ
通讯作者：
Qiang, DJ