Objective: To analyze the change trend of HIV genetic subtypes and compare the first CD(4)(+)T cell counts of newly diagnosed HIV infected patients in Liuzhou from 1998 to 2012, and provide a reference for AIDS prevention and control. Methods: Newly diagnosed HIV-infected patients from 1998 to 2012 in Liuzhou were selected through national HIV/ADIS comprehensive response information management system. Their plasma samples were used for RNA gene extraction, amplification, sequencing and genotyping. Coharan-Armitage trend test was used to analyze the ratio trend of genetic subtypes and phylogenetic clusters of HIV and Wilcoxon Rank Sum Test was used to compare the first CD(4)(+)T cell counts (CD(4)) of the different subtype HIV infected patients. Results: A total of 1 877 newly diagnosed HIV infected patients were included in the study. From 1998 to 2012, the proportions of CRF01_AE and CRF01_AE (Cluster 1) increased from 78.4% (76/97) to 91.5% (1 441/1 574), from 63.9% (62/97) to 74.0% (1 164/1 574), and the proportion of CRF07_BC decreased from 17.5% (17/97) to 4.6% (72/1 574), respectively (Z=4.632, P<0.001; Z=2.455, P=0.014; Z=-5.943, P<0.001). The median and interquartile range of the first CD(4) of the patients infected with subtype CRF01_AE (Cluster 1), CRF01_AE (Cluster 2), CRF07_BC and CRF08_BC were 230 (83-375), 215 (48-351), 365 (254-503) and 334 (206-479) cell/μl, respectively. The first CD(4) levels of the patients infected with subtype CRF01_AE (Cluster 1) or CRF01_AE (Cluster 2) were significantly lower than those of CRF07_BC (Z=-4.795, P<0.001; Z=-4.238, P<0.001). Conclusion: The genetic subtypes of HIV were mainly CRF01_AE in newly diagnosed HIV-infected patients and this subtype proportion was in increase and the first CD(4) levels of the patients were low in Liuzhou during 1998 to 2012.
目的： 分析柳州市1998－2012年新发现HIV基因亚型变化，比较HIV感染者首次CD(4)(+)T淋巴细胞计数（CD(4)），为艾滋病防治提供参考依据。 方法： 选取我国艾滋病综合防治信息系统中1998－2012年柳州市新发现HIV感染者，对其血浆进行RNA提取、扩增、测序和分型。采用Coharan-Armitage趋势检验法分析HIV基因亚型变化的趋势，采用Wilcoxon秩和检验法分析比较HIV感染者的首次CD(4)。 结果： 研究对象共有1 877例HIV感染者。1998－2012年，CRF01_AE、CRF01_AE（Cluster 1）和CRF07_BC亚型构成比分别从78.4%（76/97）上升至91.5%（1 441/1 574）、63.9%（62/97）上升至74.0%（1 164/1 574）和17.5%（17/97）下降至4.6%（72/1 574），趋势性检验差异均有统计学意义（Z=4.632，P<0.001；Z=2.455，P=0.014；Z=-5.943，P<0.001）。CRF01_AE（Cluster 1）、CRF01_AE（Cluster 2）、CRF07_BC和CRF08_BC亚型HIV感染者首次CD(4)的中位数及四分位数间距分别是230（83~375）、215（48~351）、365（254~503）和334（206~479）个/μl。CRF01_AE（Cluster 1）和CRF01_AE（Cluster 2）亚型HIV感染者的首次CD(4)均<CRF07_BC亚型（Z=-4.795，P<0.001；Z=-4.238，P<0.001）。 结论： 1998－2012年柳州市新发现HIV感染者以CRF01_AE亚型为主并呈上升趋势，其首次CD(4)较低，且新发现CRF01_AE亚簇的种类在增加，其亚簇构成比存在变化趋势。.
Keywords: CD(4)(+)T cell counts; Genetic subtypes; HIV-1.