Objective: To understand the characteristics and dynamics of individuals with HIV-1 subtype infection among injected drug users (HIV infection IDU) in Guangzhou between 2008 and 2015. Methods: HIV-1 RNAs were extracted from serum samples of the individuals that were newly diagnosed with HIV-1 infection among IDUs living in Guangzhou, between 2008 and 2015. The Pol gene segments of HIV-1 genome from these RNA samples were amplified by nested reverse transcription polymerase chain reaction (Nested-PCR) and sequenced. Subsequently, phylogenetic tree was reconstructed using both pol sequences of samples and references before the subtype of HIV-1 was determined. Distributions of HIV-1 subtypes detected in IDUs with different demographic characteristics in different years were compared. Results: A total of 437 pol gene segments were successfully obtained from 517 serum samples of HIV infection IDUs. The average age of 437 HIV infected IDUs was 37.37 years with standard deviation as 8.17 years. 51.5% (225/437) of the HIV infected IDU that registered residence were not in Guangdong. The Guangxi Registered residents were accounted for 54.2% (122/225). Proportion of subtype CRF07_BC (46.5%) appeared the highest, followed by CRF01_AE (24.3%), CRF08_BC (23.3%) and other subtypes (5.9%). The annual proportions of subtype CRF07_BC (trend χ(2)=19.703, P=0.006) and CRF08_BC (trend χ(2)=25.718, P=0.001) were significantly different. The proportion of subtype CRF07_BC decreased from 56.9% to 34.2% (trend χ(2)=15.139, P=0.000), while the proportion of CRF08_BC increased from 11.8% to 37.0% (trend χ(2)=22.577, P=0.000). The proportion of CRF08_BC was significantly higher in the HIV infected IDUs with Guangxi residence (Monte Carlo simulation of exact probability P=0.000, 99%CI: 0.000-0.000). Conclusions: CRF07_BC, CRF01_ AE and CRF08_BC were the predominant HIV-1 subtypes while multiple subtypes were co-circulated among the HIV infected IDUs in Guangzhou, between 2008 and 2015. Behavioral intervention set for HIV infected IDUs with Guangxi residence should be strengthened in Guangzhou.
目的： 了解2008-2015年广州市注射吸毒人群HIV感染者（IDU感染者）HIV-1亚型分布特征及变化趋势。 方法： 研究对象为2008-2015年确证的HIV-1感染者、注射吸毒途径感染、现住址为广州市。收集血清样本提取HIV-1 RNA，采用巢式PCR法扩增HIV-1 pol区基因片段，测序后构建系统进化树，确定HIV-1亚型，比较不同年份和不同特征样本的HIV-1亚型分布。 结果： 从517份血清样本中成功获得437份样本的pol区基因片段。437份样本的年龄（37.37±8.17）岁；外省户籍者占51.5%（225/437），以广西壮族自治区户籍（广西籍）居多（54.2%，122/225）。HIV-1亚型分布以CRF07_BC（46.5%）、CRF01_AE（24.3%）和CRF08_BC（23.3%）为主。CRF07_BC和CRF08_BC在2008-2015年各年份构成比的差异有统计学意义（CRF07_BC：趋势χ(2)=19.703，P=0.006；CRF08_BC：趋势χ(2)=25.718，P=0.001），其中CRF07_BC的构成比呈下降趋势（趋势χ(2)=15.139，P=0.000），CRF08_BC的构成比呈上升趋势（趋势χ(2)=22.577，P=0.000）。广西籍IDU感染者中CRF08_BC亚型的构成比较高（蒙特卡罗模拟精确概率P=0.000，99%CI：0.000~0.000）。 结论： 2008-2015年广州市IDU感染者HIV-1亚型分布以CRF07_BC、CRF01_AE和CRF08_BC为主、多个亚型共存，CRF08_BC亚型的构成比呈上升趋势的特点。提示广西籍IDU感染者是广州市艾滋病防治重点人群，应加强干预。.
Keywords: Characteristics; HIV-1; Injected drug users; Subtype.