【摘要】 目的 通过构建湖南省HIV-1毒株pol基因区序列的分子网络，分析毒株在湖南省的跨地区传播特征，为HIV精准防控提供数据支持。方法 采集湖南省2023年新报告539例HIV感染者血样，采用巢式PCR扩增pol区基因，利用系统进化树与在线工具鉴定亚型，HIV-TRACE构建分子传播网络，对跨地区连接影响因素进行单因素与多因素Logistic回归分析。结果 共采集样本539份，获得有效序列490条。在1.5%基因距离阈值下，形成66个传播簇和179条边，入网率40.61%(199/490)。跨市分子簇21个，跨市传播节点占36.68%(73/199)，跨市连接占30.17%(54/179)。最大的跨市传播簇为CRF07＿BC亚型，共涉及10个市州，簇中63.89%(23/36)为MSM。以长沙为中心形成的跨地区连接边最多。多因素分析显示30岁以下（OR=3.508,95%CI:1.007～12.220），受教育程度为高中及以上（OR=3.056,95%CI:1.019～9.163）者跨地区连接风险较高。结论 同性性行为感染者是湖南省HIV毒株发生跨市传播的主要人群，青年和受教育程度较高的HIV感染者发生跨市传播的风险高于其他人群。更多还原

【Abstract】 Objective This study aimed to analyze the cross-regional transmission characteristics of HIV-1 strains in the Hunan Province by constructing a molecular network based on pol gene sequences to provide valuable data for the effective prevention and control of HIV. Methods Blood samples were collected from 539 newly HIV-infected individuals in the Hunan Province in 2023. Nested polymerase chain reaction was used to amplify pol, and phylogenetic trees and online tools were used to identify the subtypes. HIV-transmission cluster engine software was used to construct a molecular transmission network, and univariate and multivariate logistic regression analyses were conducted to determine the factors affecting cross-regional transmission. Results In total, 539 blood samples were collected, yielding 490 valid sequences. At 1.5% genetic distance threshold, 66 molecular networks and 179 edges were formed, with a network entry rate of 40.61%(199/490). There were 21 cross-regional molecular clusters, with 36.68%(73/199) of nodes indicating intercity transmission and 30.17%(54/179) indicating cross-regional connections. The largest cross-regional transmission cluster, involving 10 municipalities, belonged to the CRF07＿BC subtype, with 63.89%(23/36) of infections observed in men who have sex with men. Connections centered around Changsha constituted the major interregional edges.Multivariate analysis indicated that factors associated with high cross-regional connection risks included being under 30years of age(OR: 3.508;95% CI: 1.007-12.220) and having a high school education or above(OR: 3.056;95% CI: 1.019- 9.163). Conclusions Individuals engaging in homosexual behavior were the main population responsible for the cross-regional transmission of HIV strains in the Hunan Province. Among the HIV-infected individuals, young individuals and those with high level of education exhibited a higher risk of crossregional transmission than the other populations.更多还原