3.1 Basic characteristics of the research object
A total of 109 cases of sexually transmitted and successfully obtained Pol gene region sequences were screened. Among them, 102 were males (93.6%), the median age was 39 years (interquartile range, IQR, 29–52), 96 were Han (88.1%), 42 were junior high school or below (38.5%), and 53 were unmarried. (48.6%), 92 cases (84.4%) currently living locally, 30 cases (27.5%) in housekeeping, housework and job hunting, 83 cases (76.1%) of same-sex transmission, 181 CD4 cells / ul ( IQR, 62–260) The HIV viral load is 49700 copies / ml ( IQR, 13950–147000). See Table 1 for details.
Table 1
Demographic characteristics of the study objects
project | Median ( IQR ) | Frequency(%) |
Gender | | |
Male | | 102 (93.6) |
Female | | 7 (6.4) |
Age | 39 (28–52) | |
Nation | | |
Han nationality | | 96 (88.1) |
Others | | 13 (11.9) |
Educational level | | |
Junior high school and below | | 42 (38.5) |
High school or technical secondary school | | 28 (25.7) |
College and above | | 39 (35.8) |
Marital status | | |
Unmarried | | 53 (48.6) |
Married with spouse | | 27 (24.8) |
Divorced or widowed | | 29 (26.6) |
Place of residence | | |
Local | | 92 (84.4) |
Nonlocal | | 17 (15.6) |
Occupation | | |
Housekeeping, housework and job hunting | | 30 (27.5) |
Worker | | 10 (9.2) |
Business waiter | | 7 (6.4) |
Cadre staff | | 10 (9.2) |
Retired | | 10 (9.2) |
Farmer | | 9 (8.3) |
Others and unknown | | 33 (30.3) |
Route of infection | | |
Male same-sex transmission | | 83 (76.1) |
Heterosexual transmission | | 26 (23.9) |
Sample source | | |
Testing Consulting | | 32 (29.4) |
STD clinic | | 22 (20.2) |
Other visitor tests | | 29 (26.6) |
Other sources | | 26 (23.9) |
CD4 cells (cells /ul) | 181 (62–260) | |
HIV viral load (copy /ml) | 49700 (13950–147000) | |
3.2 Analysis of HIV-1 subtypes
The subject's HIV-1 subtype was mainly CRF01_AE subtype in 83 cases (76.1%), followed by B subtype in 11 cases (10.1%), CRF07_BC subtype in 8 cases (7.3%), and B + C subtype in 5 cases ( 4.6%), 1 case each of subtype A and C (0.9%). see Fig. 1. Fourteen patients (12.8%) developed HIV resistance in the study subjects, of which nine were protease inhibitor-related resistance, and the resistance sites were mainly L33F, V82A, Q58E, M46L, and M46I; there were 4 cases of nucleosides. Reverse transcriptase inhibitor resistance, the main mutation sites were V75VI, K219Q, T215A, K65R; there were 5 cases of non-nucleoside reverse transcriptase inhibitor resistance, the main mutation sites were V179E, A98G, V106I, Y181C, G190S, V179D.
1. 3.3 Molecular propagation network analysis
2. 3.3.1 HIV-1 Molecule Transmission Rate and Its Influencing Factors
Under the 0.55% genetic distance threshold, a total of 66 series entered the HIV = 1 molecular transmission network, with a total access rate of 60.6% (Fig. 2).
Whether to enter the HIV-1 molecular transmission network as the dependent variable, and take gender, age, ethnicity, education level, marital status, place of residence, occupation, route of infection, sample source, genotype and resistance as independent variables Factors and multi-factor Logistic regression analysis (Table 2), the results showed that workers, sample source testing consultation and other visitor testing, subtype B and drug resistance were influencing factors for entering the HIV-1 molecular transmission network.
Table 2
Analysis of the influencing factors of HIV-1 entering the molecular transmission network of sexually transmitted people in Liaoning Province
Project | Total | Internet access rate (%) | One-factor logistic analysis | | Multifactor Logistic Analysis |
OR (95% CI) | P value | | aOR (95% CI) | P value |
Gender | | | | | | | |
Male | 102 | 64 (62.7) | 0.238 (0.044–1.285) | 0.095 | | | |
Female | 7 | 2 (28.6) | 1 | | | | |
Age | | | | | | | |
≤ 30 | 36 | 22 (61.1) | 1 | | | | |
31–50 | 44 | 25 (56.8) | 1.194 (0.497–2.929) | 0.698 | | | |
> 50 | 29 | 19 (65.5) | 0.287 (0.299–2.288) | 0.715 | | | |
Nation | | | | | | | |
Han nationality | 96 | 60 (62.5) | 1 | | | | |
Others | 13 | 6 (46.2) | 1.944 (0.606–6.241) | 0.264 | | | |
Educational level | | | | | | | |
Junior high school and below | 42 | 26 (61.9) | 1.099 (0.445–2.712) | 0.838 | | | |
High school or technical secondary school | 28 | 15 (53.6) | 1.548 (0.575–4.164) | 0.387 | | | |
College and above | 39 | 25 (64.1) | 1 | | | | |
Marital status | | | | | | | |
Unmarried | 53 | 30 (56.6) | 0.944 (0.379–2.347) | 0.901 | | | |
Married with spouse | 30 | 20 (66.7) | 0.431 (0.139–1.333) | 0.144 | | | |
Divorced or widowed | 29 | 16 (55.2) | 1 | | | | |
Place of residence | | | | | | | |
Local | 92 | 55 (59.8) | 1.233 (0.419–3.626) | 0.703 | | | |
Nonlocal | 17 | 11 (64.7) | 1 | | | | |
Occupation | | | | | | | |
Housekeeping, housework and job hunting | 30 | 14 (46.7) | 3.571 (1.223–10.429) | 0.020 | | 3.018 (0.810-11.239) | 0.100 |
Worker | 10 | 4 (40.4) | 4.687 (1.051–20.899) | 0.043 | | 7.154 (1.057–48.417) | 0.044 |
Business waiter | 7 | 2 (28.6) | 7.812 (1.262–48.356) | 0.027 | | 8.778 (0.898–85.767) | 0.062 |
Cadre staff | 10 | 7 (70.0) | 1.339 (0.279–6.434) | 0.715 | | 1.156 (0.185–7.214) | 0.877 |
Retired | 10 | 8 (80.0) | 0.781 (0.137–4.460) | 0.781 | | 0.617 (0.068–5.594) | 0.668 |
Farmer | 9 | 6 (66.7) | 1.562 (0.316–7.726) | 0.584 | | 3.228 (0.430-24.252) | 0.255 |
Other and unknown | 33 | 25 (75.8) | 1 | | | 1 | |
Route of infection | | | | | | | |
Same-sex transmission | 83 | 51 (61.4) | 0.856 (0.350–2.094) | 0.733 | | | |
Heterosexual transmission | 26 | 15 (57.7) | 1 | | | | |
Sample source | | | | | | | |
Testing Consulting | 32 | 14 (43.8) | 7.071 (1.978–25.278) | 0.003 | | 6.984 (1.476–33.043) | 0.014 |
STD clinic | twenty two | 14 (63.6) | 3.143 (0.795–12.425) | 0.103 | | 2.138 (0.415–11.014) | 0.364 |
Other visitor tests | 29 | 16 (55.2) | 4.469 (1.227–16.275) | 0.023 | | 6.088 (1.316–28.151) | 0.021 |
Other sources | 26 | 22 (84.6) | 1 | | | 1 | |
HIV genotype | | | | | | | |
CRF01_AE | 83 | 57 (68.7) | 1 | | | 1 | |
B | 11 | 4 (36.4) | 3.837 (1.032–14.263) | 0.045 | | 7.142 (1.356–37.621) | 0.020 |
CRF07_BC | 8 | 5 (62.5)) | 1.315 (0.292–5.923) | 0.721 | | 2.093 (0.369–11.869) | 0.404 |
Others | 7 | 0 (0.0) | — | — | | — | — |
Whether HIV is resistant | | | | | | | |
Resistance | 15 | 3 (20.0) | 8.129 (2.137–30.928) | 0.002 | | 7.184 (1.286–40.121) | 0.025 |
Not resistant | 94 | 63 (67.0) | 1 | | | 1 | |
3.3.2 Characteristics of HIV-1 molecular transmission network
The CRF01_AE subtype propagates in the molecular network to form six propagation clusters, one of which is the largest propagation cluster in the network and contains 40 nodes. Subtype B forms two propagation clusters, each consisting of two nodes. The CRF07_BC subtype forms a propagation cluster consisting of 5 nodes. In the network, the median CRF01_AE subtype connectivity is 3 degrees ( IQR, 2–7), the median connectivity of subtype B is 1 degree ( IQR, 1–1), and the median connectivity of CRF07_BC subtype is 2 degrees ( IQR, 2–4), the difference in connectivity between different subtypes was statistically significant ( P < 0.01). HIV-1 resistance mutations entering the network are protease inhibitor-related resistances, which include 3 nodes, and the mutation sites are L33F and Q58E. The homosexual transmission in the network accounted for 77.3%, and the degree of connectivity was 3 degrees ( IQR, 1–6); the heterosexual transmission accounted for 22.7%, and the degree of connectivity was 3 degrees ( IQR, 2–6). The place of residence is 83.3% in the local area and 16.7% in the field, and the connectivity is 3 degrees ( IQR, 1–6).