Analysis Of Human Cytomegalovirus(HCMV) GN Genotypes In HCMV/HIV-1 Co-infected Patients

Objective to investigate human cytomegalovirus(HCMV) active infection rates in HIV infected patients from Anhui province and to determine the distribution of HCMV glycoprotein N(g N) variants amplified from blood samples of HIV-1 infected patients.To determine the difference in distribution of g N genotypes between the group of HCMV/HIV-1 co-infected patients and the group of immunocompetent patients in which pp65 antigenemia is positive. Through analyzing of g N gene sequence in HCMV/HIV-1 co-infected patients, to understand g N gene mutation and evolution in HCMV epidemic strains from Anhui province. Another aim is to study the influence of the disease progression on the patients with HCMV/HIV-1 co-infection.Methods In the present study, 359 samples of whole blood were collected randomly from HIV-1 infected patients in Hefei and Fuyang city centers for disease control and prevention(CDC) during December 2013 to July 2014, and in the same period whole blood samples were selected from 12 immunocompetent patients with HCMV pp65 antigenemia in the hospitals of Hefei. First of all, HCMV active infection in HIV-1infected patients was detected by both nested PCR and pp65 antigenemia, then the HCMV UL73 gene was amplified by nested PCR(n PCR) using Taq DNA polymerase,the amplicon were digested with MboⅠ, ScaⅠ and SalⅠ, and were analyzed by Agarose Gel Electrophoresis. PCR cloning and sequencing method was designed for mixed infection samples. Finally, the relationship between the different genotype HCMV infection and AIDS mortality and morbidity was invested through a prospective study.Results HCMV active infection rate was 7.8%(95%CI:5%~10.6%)in local HIV-1infected patients; The distribution of HCMV g N genotypes in HIV infected patients was as follows: g N-3a, 4/20(20%); g N-1, 4/20(20%); g N-4d, 1/20(5%); g N-4b, 1/20(5%),mixed infection, 10/20(50%). In the mixed infection samples, 80% samples had two g N genomic variants, and 20% samples had tree g N genomic variants. In the follow-up period, HCMV active infection patients were more likely to turn into AIDS patients(RR= 9.78), and the related mortality risk was 4.6 times as higher in g N-1 and g N-4genotypes HCMV infection patients as other genotypes.Conclusions HCMV g N genotype diversities were found in HCMV/HIV-1 co-infected patients from Anhui, HCMV g N-3a and g N-1 genotypes were prevalent among the HIV-1 infected patients examined. The distribution of HCMV g N genotypes in different populations have obvious difference, the rate of HCMV mixed infection in HIV-1infected patients was higher than the immunocompetent patients. HCMV secondary infection or multiple infection is common in patients with HIV/AIDS. HCMV infection(especially g N-1 and g N-4) may accelerate the disease progression in HIV-1 infected patients.