| Objective :Human immunodeficiency virus(HIV), Hepatitis B virus,(HBV), Hepatitis C virus(HCV) and Treponema pallidum(TP) has a similar route of transmission, therefore, it is necessary and useful to understand the Infection status of HIV infections from 2002 to 2014 and analyze the related factors like gender, nationality, age, marital status, educational level and other related influencing factors in ningxia hui autonomous region. At the same time, test part of Ningxia type Ⅰ AIDS(HIV-1) pol zone Subtypes genotyping to understand the distribution of HIV-1 genetic subtypes in Ningxia. Thus, we can provide a scientific basis and reference for the work of AIDS prevention and control.Methods :HIV/AIDS patients were collected from 2002 to the end of 2014 in the population of permanent residents of ningxia hui autonomous region(including the cases confirmed in ningxia hui autonomous region, and provincial reported of resident population living with HIV/AIDS patients of ningxia). The personal information verification was confirmed in HIV/AIDS information management system,aimed to understand the the basic situation of HIV infection and co-infection with HBV, HCV, and TP; Enzyme-linked immunoassay and toluidine red unheated serum test were used for serological detection; Excel and SPSS statistical software were used for data analysis; ROCHE company High Pure Kit was used for HIV RNA Viral RNA extraction, based on this template, Nest- polymerase chain reaction(PCR) was uesd for HIV- 1 pol area total length amplification, after amplification sequenced, it was send to the sequencing of PCR products company, the online tools Quality control and BioEdit software provided by Los Alamos HIV Database wrere used for sequence correct and tailor, the online subtype analysis tool Genotyping provide by NCBI was used for preliminary analysis, Mega6.0 software was used to construct some strains Neighor- Joining system of evolutionary tree classification.Results :(1)From the year 2002 to 2014, AIDS confirmatory laboratory of ningxia hui autonomous region has confirmed a total of 1235 people living with HIV/AIDS, 920 people living with HIV, and 315 AIDS patients were included; Male 1051, accounted for 85.1%, female 184, accounted for 14.9%, the ratio between men and women was 5.7:1; Han nationality, accounted for 67.8%; ages ranged from 18 to 40 years of sexually active people, accounted for 58.2%; Marital status to unmarried majority, accounted for 39.8%; education mainly below junior high school and in the low education group.(2)From 2002 to 2007, the infection of HIV/AIDS people in ningxia hui autonomous region were given priority with the transmittion through blood, after 2007, the route of transmission was turned into sexual way, and continued to rise; Mother-to-child transmission controled smoothly; The first person infected HIV through homosexual transmission was occured in 2006, with the rised trend evident, heterosexual transmission was controled smoothly.(3)Among the confirmed 1235 cases of HIV/AIDS, the co-infection rate was 27.3%. Among them, the cases co-infection with HBV was 122, the positive rate was 9.9%; the cases co-infection with HCV was 267, the positive rate was 21.6%; the cases co-infection with TP was 68, the positive rate was 5.5%. Triple infection of hepatitis B surface antigen detection and hepatitis C antibody detection was 53 cases, triple infection rate was 4.3%; Hepatitis B surface antigen detection and treponema pallidum antibody test were positive for 36 cases, triple infection rate was 2.9%; Hepatitis C antibody detection and treponema pallidum antibody test were positive for 44 cases, triple infection rate was 3.6%. Four tests all positive for 12 cases, quadruple infection rate was about 1. 0%.(4)Since the year of 2007, the AIDS prevention and control system was established in Ningxia Hui Autonomous Region, the highest HIV/AIDS positive rate was in 2007, which was 13.65?, 2008 to 2014, the positive detection rate in HIV/AIDS was relatively stable, which was 2.67?-3.55?; The highest combined infection rate was in 2005, which was 78.38%, and in 2013 was the lowest 12.68%.(5)While define co-infection or not as dependent variable, gender, age, nationality, marital status, educational level and the route of transmission as independent variables, Logistic regression analysis was used for the test, there were two variables entered into the equation, nationality and the route of transmission were the influencing factors of HIV/AIDS infection, among them, the minorities was the protection factor in HIV co-infection.(6)The patients with highly active antiretroviral therapy in this study, determination of viral load was more than 1000 copies/ml samples, a total of 47 of the plasma for HIV- RNA extraction, Nest- PCR amplification was used for the test, got 35 target gene fragment, after the sequenced analysis, there were four kinds of genetic subtype, the B subtype, CRF07_BC, CRF08_BC and CRF01_AE subtypes, the largest was CRF07_BC subtype, for 23 cases, accounted for 65.7%. CRF07_BC, CRF01_AE and subtype B were 17.1%, 11.5% and 5.7%, respectively.Conclusion:(1)From 2002 to 2014, HIV/AIDS in Ningxia Hui Autonomous Region continued to increase, the epidemic become worsening, the treatment and prevention can not be ignored, we should perfect the intervention measures, and increase the intervention efforts.(2)From 2002 to 2007, the route of transmission of AIDS is mainly transmitted through blood, from 2008 to 2014 it has been transformed into sexual transmission, suggesting that the AIDS epidemic in our region tutns from high-risk groups into the general population transfer.(3)The control of heterosexual transmission is smoothly, while the homosexual transmission continue to rise, we should pay attention to strengthen publicity and education between the MSM population, give promotion of voluntary counseling and testing services for those who in need of counseling to give proper guidance and assistance;(4)Double, triple, quadruple infection are all presented, suggesting that while strengthen the monitoring of the AIDS epidemic, publicity and education need to provide at the same time on the same route of transmission disease like HBV,HCV, syphilis, aim to improve the awareness of various types of sexually transmitted diseases, focusing on prevention and control of sexually active people.(5)Accroding to our study on the characteristics of ningxia popular subtype strains of HIV-1, there exist four genotypes, B, CRF07_BC, CRF08_BC and CRF01_AE genotype, mainly of recombinant subtypes, in which CRF07_BC is the most. The genotype of HIV-1 tends to be diversification, it will even more difficult for the prevention and control of AIDS, we need to strengthen the management of drug addicts and the education of sexual active people, popularize the knowledges of AIDS control and prevention. |
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