【摘要】 目的对上海市2013年新发现的男男性行为(MSM)人群未经抗病毒治疗的艾滋病病毒1型(HIV-1)感染现况进行调查,为上海市老年人群医疗保障措施及艾滋病防治对策提供参考。方法知情同意前提下,对新发现HIV感染者进行个案流行病学调查并采集血样,进行反转录-聚合酶链反应扩增、DNA测序与亚型鉴定。将52例≥50岁年龄组与591例<50岁年龄组人群做相应对比,揭示该人群人口学、行为学及基因亚型的分布特征。结果≥50岁MSM人群亚型分析结果以CRF01_AE为主,占48.1%(25/52),其次为CRF07_BC占26.9%(14/52),B亚型占11.5%(6/52),CRF08_BC占3.8%(2/52),01B亚型为9.6%(5/52)。CRF01_AE在≥50岁年龄组中的比例(48.1%)明显低于<50岁年龄组的63.8%(χ2=11.18,P<0.05),并且在病程进展及死亡等方面差异有统计学意义,提示在≥50岁年龄组可能更容易进展到艾滋病期。结论上海市≥50岁MSM人群感染者以上海本地户籍为主,虽然基因亚型也以CRF01_AE亚型为主,但基因亚型呈多样性。应重视该人群亚型的发展和演变,有针对性地加强本地户籍≥50岁男性艾滋病宣传、高危行为干预,制定科学并有针对性的艾滋病防治策略。更多还原

【Abstract】 Objective To understand the demographic and behavioral characteristics as well as HIV subtypes of HIV-infected men who have sex with men( MSM) reported in 2013 in Shanghai,and provide evidence for the prevention and control of HIV infection in MSM. Methods On the basis of informed consent,epidemiological investigation were conducted among newly reported MSMinfected with HIV,and blood samples were collected from them. RT-PCR and nested PCR were conducted to amplify HIV-1 pol protease and partial reverse transcriptase genes,and phylogenetic analysis was performed The comparison between HIV infected MSMaged ≥ 50 years and HIV infected MSMaged < 50 years was conducted to reveal their demographic and behavioral characteristics and HIV subtypes. Results The most common HIV subtype was CRF01_ AE,accounting for 48. 1%( 25 /52),followed by CRF07_ BC( 26. 9%,14 /52),subtype B( 11. 5%,6 /52),CRF08_ BC( 3. 8%,2 /52),subtype 01B( 9. 6%,5 /52). The proportion of CRF01_AE was significantly lower in ≥50 years old MSM( 48. 1%) than in MSMaged < 50 years( 63. 8%)( χ2= 11. 18,P < 0. 05),and the differences in disease progression and mortality were significant,indicating that AIDS was more likely to develop in HIV infected MSMaged ≥ 50 years.Conclusion Most ≥50 years old MSMinfected with HIV in Shanghai were local residents,and the genetic subtypes of HIV-1 strains among ≥50 years old MSMwere different,mainly CRF01_AE. We should pay attention to the subtype of CRF01_AE,develop appropriate and targeted strategies,strengthen high-risk behavior intervention in local males aged ≥50 years for AIDS prevention and control.更多还原