| ObjectiveTo understand the epidemiological characteristics of newly reported HIV/AIDS and monitor HIV-1 subtypes and transmission drug resistance of HIV-1 infected individuals aged 16-25 in Longgang District,Shenzhen.To provide scientific basis for the precise prevention and control of HIV/AIDS in this region.Methods1.Descriptive study,used for the analysis HIV/AIDS from January2016 to December 2019 in Longgang District of Shenzhen.The data were downloaded from the National HIV/AIDS Comprehensive Response Information Management System.The distribution of HIV/AIDS and the transmission routes,contact modes and sample sources were described and analyzed.Arc GIS software was used to construct the map of the household registration distribution of HIV/AIDS.The influencing factors of death were analyzed by using univariate and multivariate Logistic regression.2.Epidemiological information and WB pattern of HIV/AIDS aged16-25 years from January 2016 to December 2019 in Longgang District of Shenzhen were collected and analyzed using descriptive study methods.Collected serum samples and extracted HIV RNA.The whole protease gene(PR)and partial reverse transcriptase gene(RT)sequences in the pol region of viral RNA were amplified using nested Reverse Transcription-Polymerase Chain Reaction(RT-PCR).The PCR products successfully amplified were sent to GENEWIZ that a third-party detection company for purification and sequencing.DNASTAR Lasergene software was used to edit and splice the sequence.The HIV-1 subtypes were identified by Neighbor-Joining of MEGA 7.0 software to construct phylogenetic tree.HIV drug resistance was determined by HIV db Program in Stanford University HIV Drug Resistance Database.Cluster Picker software was used to extract molecular transmission clusters.Statistical analysis was performed by SPSS 25.0 software.Qualitative variables were described by frequency and composition ratio,while quantitative variables with normal distribution were described by mean and standard deviation.Results1.From 2016 to 2019,the reported incidence rates of HIV/AIDS in Longgang District of Shenzhen were 15.60/100,000,19.48/100,000,21.74/100,000 and 19.93/100,000,respectively.A total of 1806 HIV/AIDS were reported.The males HIV/AIDS accounted for(88.87%,1605/1806)and the“non-local residents”who have household registrations in other regions accounted for(66.45%,1200/1806).A lot of young and middle-aged individuals were identified,of which the aged 25-34 years and 35-44years accounted for 38.10%(688/1806)and 21.93%(396/1806),respectively.Only 11.46%(207/1806)of HIV/AIDS knew their self-infection through active HIV testing.The HIV/AIDS of men who have sex with men(MSM)and heterosexuals accounted for 50.17%(906/1806)and42.36%(765/1806),respectively.But 4.04%(73/1806)had multiple high-risk behaviors.The infection route of HIV/AIDS was mainly sexual transmission(99.22%,1792/1806),homosexual and heterosexual transmission accounted for 53.54%(967/1806)and 45.68%(825/1806),respectively.However,the number of HIV/AIDS in MSM reported per year was decreasing(χ~2=17.78,P<0.001)and decreased with increased age(χ~2=173.95,P<0.001),heterosexual transmission was the opposite.The infection route of different marital status was different(χ~2=208.71,P<0.001),majority of unmarried persons were infected by homosexual transmission.Fifty-three patients died,with an average age of 47.64±13.30 years.The risk of death increases with older age at diagnosis(45-54years:OR=8.282,95%CI:1.064-64.451;55-76 years:OR=18.035,95%CI:2.360-137.805)and progression to AIDS(OR=8.566,95%CI:3.846-19.079).2.A total of 307 HIV/AIDS aged 16-25 years were reported.The males accounted for 91.86%(282/307).The unmarried accounted for 95.11%(292/307).The“non-local residents”who have household registrations in other regions accounted for 62.54%(192/307).Sexual contact as the predominant of transmission.The homosexual transmission and heterosexual transmission accounted for 69.71%(214/307)and 29.97%(92/307),respectively.A total of 173 partial pol genes were successfully obtained from the nucleic acid samples.The HIV-1 subtypes were predominated by CRF07＿BC(43.35%,75/173),CRF01＿AE(32.95%,57/173)and CRF55＿01B(13.87%,24/173).Subtype B(5.78%,10/173),CRF59＿01B(1.73%,3/173),CRF68＿01B(1.73%,3/173)and CRF08＿BC(0.58%,1/173)were co-prevalent.A higher number of CRF01＿AE were identified in females compared to males(P<0.05).The composition ratio of CRF01＿AE increased year by year.The proportions of CRF59＿01B and CRF55＿01B showed an increasing trend(P<0.05).The overall transmitted drug resistance(TDR)rate in this population was 5.78%(10/173).Protease Inhibitors(PIs)-associated TDR,nucleoside RT inhibitors(NRTIs)-associated TDR and nonnucleoside RT inhibitors(NNRTIs)-associated TDR were 0.00%,2.31%(4/173)and 4.05%(7/173),respectively.NNRTIs resistance mainly targets EFV and NVP in first-line antiretroviral therapy(ART)regimens.The NRTIs-associated mutations were mainly M184I and T25I/S.There formed four molecular transmission clusters with CRF07＿BC which the epidemiological characteristics were mainly single and MSM.Conclusion1.The HIV/AIDS patients in Longgang District were mainly homosexuals,most of which were concentrated in young and middle-aged unmarried groups.Meanwhile,the proportion of heterosexual HIV transmission was increasing year by year,tending to be collected in the middle-aged and elder people.The risk of death increased with an older age at diagnosis and progression to AIDS-stage.We should focus on young unmarried MSM populations and middle-aged and elderly heterosexual transmission populations.2.Among the HIV-1 infected persons aged 16-25 years in Longgang District of Shenzhen from 2016 to 2019,the HIV-1 subtypes showed coexistence of multiple subtypes,among which CRF07＿BC and CRF01＿AE were the dominant strains.The proportion of CRF55＿01B showed an increasing trend.The overall TDR rate(5.78%)in this population reached the moderate drug resistance level.It’s suggested to monitor the treatment effect of HIV/AIDS in the area and conduct epidemiological investigation and precise intervention to those who are infected in the transmission cluster of CRF07＿BC subtype,so as to cut the transmission chain. |
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