Objective: To understand the molecular subtypes and recombinant structure of HIV-1 infection in Zhejiang Province. Methods: According to the method of stratified random sampling method, a total of 302 newly HIV infected people (excluding AIDS patients) were selected as the subjects of the investigation from April to June, 2015, who were all newly HIV positive patients reported in Zhejiang Province and were diagnosed as HIV positive and had not received antiretroviral treatment. Questionnaires were used to collect information such as gender, residency, marital status, route of transmission and case reporting area. At least 8 ml of venous blood was collected from HIV infected people, reverse transcription-polymerase chain reaction (RT-PCR) and nested PCR were used to amplify the pol gene sequence of HIV-1 strains and circulating recombination forms (CRF) and unique recombinant form (URF) strains were screened using phylogenetic tree, and molecular subtype analysis and recombinant analysis were performed. Results: Of the 302 HIV infected people, 18 cases were infected with new CRFs or URFs, among which 15 were male (83.3%), 3 were heterosexual transmission (17.7%); 8 cases (44.4%) were infected with new CRFs, which included CRF55_01B 5(27.8%), CRF67_01B 2 (11.1%), CRF69_01B 1 (5.6%); 10 cases (55.6%) were infected with URFs, in which 6 cases were infected with two groups of recombinant strains composed of CRF01_AE subtype and CRF07_BC subtypes in pol region, 3 cases were infected with three groups of recombinant strains of the two subtypes in pol region, and 1 case could not be accurately determined of the recombinant structure. The results of recombinant source analysis showed that the newly recombinant strains found from Zhejiang province were highly homologous to the strains from Guangdong, Anhui, Hebei, Yunnan, Liaoning province, and the sequence similarity was 94.4%-98.0%. Conclusion: The new recombinant strains of Zhejiang province included CRFs strains and URFs strains with CRF01_AE and CRF07_BC as the main recombinant structure mode, and all of them were introduced from other places and formed a trans-regional chain of HIV transmission.
目的： 了解浙江省HIV-1新重组型毒株的分子亚型特征和重组结构。 方法： 于2015年4—6月，按照感染途径，采用分层随机抽样的方法抽取浙江省新报告的现住址为本省，且经实验室确诊、未接受抗病毒治疗的302例HIV感染者（不包括艾滋病患者）为调查对象。采用调查问卷收集调查对象的性别、户籍地、婚姻状况、传播途径和报告地区等信息。采集HIV感染者至少8 ml静脉血，运用RT-PCR和巢式PCR扩增感染者HIV-1毒株pol区基因序列，通过系统进化树筛选新流行重组型（CRF）毒株和独特重组型（URF）毒株，并对其进行分子亚型分析和重组分析。 结果： 302例感染者中，发现18例感染了新CRF毒株或URF毒株，其中男男性行为传播为15例（83.3%），异性性传播途径为3例（17.7%）；感染新CRF毒株为8例（44.4%），分别是CRF55_01B亚型为5例（27.8%）、CRF67_01B亚型为2例（11.1%）和CRF69_01B亚型为1例（5.6%）；感染URF毒株为10例（55.6%），其中6例在pol区序列为CRF01_AE亚型和CRF07_BC亚型组成的两段重组毒株，3例在pol区序列为该两种亚型组成的三段重组毒株，另外1例尚不能准确判断其重组结构。重组来源分析的结果显示，浙江省2015年新发现的重组毒株与广东、安徽、河北、云南、辽宁等省份检测发现的毒株有较高同源性，序列相似度为94.4%~98.0%。 结论： 浙江省新型重组毒株主要为CRF毒株和以CRF01_AE和CRF07_BC为重组结构模式的URF毒株，且均为外地流行传播引进，跨地区形成传播链。.
Keywords: Genotype; HIV-1; Molecular epidemiology; Recombinant structure.