Molecular epidemiology of HIV/AIDS and related diseases in Southern Africa

南部非洲是世界上HIV-1感染率最高的国家，为了改善这种情况，以下战略是优先考虑的：1.了解南部非洲艾滋病毒感染的自然历史，2.为艾滋病毒感染者开发负担得起的有效治疗方法，3.开发安全有效的艾滋病毒疫苗，4.开发和实施预防艾滋病毒母婴传播(MTCT)的机制，5.开发更快的结核病耐药性监测方法。为了了解艾滋病毒感染的自然历史，我们招募了没有症状的患者，并对他们进行了3年的跟踪调查。结核病被确定为这些患者的最高死因。为了确定一种有效和负担得起的艾滋病毒治疗药物，进行了一项双盲研究。为了确定HIV-1毒株在赞比亚疫苗研发中的分布，我们分析了卢萨卡的核苷酸序列，发现HIV-1包膜亚型以C亚型为主，出现了类似D和G亚型的HIV-1包膜。有必要继续进行研究，以监测赞比亚艾滋病毒-1疫情的变化动态，特别是沿边境地区。为了确定有效的母婴传播方法，我们发现，艾滋病毒在赞比亚的宫内传播和分娩期间传播同样重要。我们在卢萨卡发现了高比率的结核病耐药分支杆菌。

Southern Africa has the highest prevalence of HIV-1 infection in the world and the following strategies have been priority in order to improve this situation :1. To understand the natural history of HIV infection in southern Africa,2. To develop an affordable and effective treatment for HIV infected people,3. To develop a safe and effective HIV vaccine,4. To develop and implement a mechanism that would prevent mother to child transmission(MTCT)of HIV,5. To develop a faster TB drug-resistant monitoring assay.In order to understand the natural history of HIV infection, we recruited asymptomatic patients and followed them for 3 years. TB was identified as the highest cause of death in these patients.A double blinded study was carried out in order to determine an effective and affordable drug for HIV treatment. CD4 counts were high in patients who maintained high drug levels in their plasma.To determine the distribution of HIV-1 strains in Zambia for vaccine development, we analysed the nucleotide sequences in Lusaka and found the predominance of HIV-1 env subtype C like with the emergence of HIV-1 env subtypes D-like and G-like. There is a need for continued studies to monitor the changing dynamics of the HIV-1 epidemic in Zambia, especially along the bordering areas.To determine an effective prevention method of MTCT, we found that intrauterine transmission and during delivery were equally important for the transmission of HIV to babies in Zambia.We found a high rate of TB drug-resistant mycobacterium in Lusaka.