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Article(id=1241035544952631986, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241035543589483182, articleNumber=null, orderNo=null, doi=10.20043/j.cnki.MPM.202408384, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1724601600000, receivedDateStr=2024-08-26, revisedDate=null, revisedDateStr=null, acceptedDate=null, acceptedDateStr=null, onlineDate=1773815531242, onlineDateStr=2026-03-18, pubDate=1735056000000, pubDateStr=2024-12-25, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1773815531242, onlineIssueDateStr=2026-03-18, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1773815531242, creator=13701087609, updateTime=1773815531242, updator=13701087609, issue=Issue{id=1241035543589483182, tenantId=1146029695717560320, journalId=1227665162245664772, year='2024', volume='51', issue='24', pageStart='4417', pageEnd='4608', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1773815530917, creator=13701087609, updateTime=1773815686426, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1241036195896029478, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241035543589483182, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1241036195896029479, tenantId=1146029695717560320, journalId=1227665162245664772, issueId=1241035543589483182, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=4573, endPage=4579, ext={EN=ArticleExt(id=1241035545430782647, articleId=1241035544952631986, tenantId=1146029695717560320, journalId=1227665162245664772, language=EN, title=Characteristics of HIV molecular transmission network of men who have sex with men among newly reported HIV cases, Jinan, 2022-2023, columnId=null, journalTitle=Modern Preventive Medicine, columnName=null, runingTitle=null, highlight=null, articleAbstract=
Objective

To explore the characteristics of HIV molecular transmission network of men who have sex with men (MSM) among newly reported HIV cases in Jinan, China.

Methods

The plasma samples of newly reported HIV-1 MSM in Jinan from 2022 to 2023 were collected. The pol region gene was amplified using nested PCR followed by sequencing. The obtained sequences were used to construct phylogenetic tree and molecular transmission network. The related factors for participants entering a cluster were analyzed. Drug resistance mutations were identified and analyzed using the online software of HIV drug resistance database of Stanford University.

Results

This study obtained 207 sequences and identified 15 HIV-1 subtypes. The dominant subtypes were CRF07_BC (76/207, 36.7%) and CRF01_AE (74/207, 35.7%), followed by B subtypes (21/207, 10.1%), CRF114_0155 (9/207, 4.3%), and CRF55_01B (8/207, 3.9%). Setting 1.5% as the gene distance threshold, a total of 15 molecular clusters were formed by 42 sequences, with a transmission network entry rate of 20.3%. Multivariate Logistic Analysis results showed that MSM with college or above education level and CD4 count>500 cells/μl were more likely to enter the molecular transmission network. Among the 207 participants, 11(5.3%) were detected with drug resistance mutations, including 2 with PI resistance mutations, 6 with NRTI resistance mutations, 2 with NNRTI resistance mutations, and 2 with INSTI resistance mutations. One participant was detected with both NRTI and NNRTI resistance mutations.

Conclusion

The gene subtypes of newly reported HIV cases are diverse, mainly were CRF07_BC and CRF01_AE. MSM with younger age and higher education level are active populations in the HIV transmission network. HIV transmission network monitoring is a long-term and continuous work, and it is necessary to strengthen the traceability of key populations in the network and provide more effective intervention strategies to reduce the HIV transmission.

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目的

通过构建济南市新报告男男性行为人群（men who have sex with men, MSM）人类免疫缺陷病毒-1型（human immunodeficiency virus type 1, HIV-1）感染者的分子传播网络，分析传播网络特征，以提高干预效果，减少新发感染。

方法

收集2022—2023年济南市新报告HIV-1 MSM感染者的治疗前样本，采用巢氏PCR方法扩增HIV-1 pol区基因并测序，所得序列构建系统进化树确定亚型，构建分子传播网络并分析入网危险因素，通过美国斯坦福耐药数据库识别并分析耐药突变位点。

结果

本次研究共获得有效序列207条，共发现15种HIV亚型，以CRF07_BC（76例，36.7%）和CRF01_AE（74例，35.7%）为主，其次为B亚型（21例，10.1%），CRF114_0155（9例，4.3%）和CRF55_01B（8例，3.9%）等。选择1.5%为基因距离阈值时，共42条序列入网，入网率为20.3%，形成15个分子簇。Logistic回归分析显示感染者的年龄、文化程度和CD4细胞数与入网相关。多因素分析结果显示，文化程度为大专及以上、CD4计数>500个/μl更容易入网。207例患者样本中有11例存在耐药突变，治疗前耐药率为5.3%，蛋白酶抑制剂（protease inhibitor, PI）耐药突变2例，核苷类逆转录酶抑制剂（nucleotide reverse transcriptase inhibitor, NRTI）耐药突变6例，非核苷类逆转录酶抑制剂（non-nucleoside reverse transcriptase inhibitor, NNRTI）耐药突变2例，整合酶抑制剂（integrase strand transfer inhibitor, INSTI）耐药突变2例，其中有1例患者同时存在NRTI和NNRTI耐药突变。

结论

济南市HIV-1 MSM感染者中基因亚型多样，主要为CRF07_BC和CRF01_AE，年轻且文化程度较高的感染者是传播网络中的活跃人群。HIV分子传播网络监测是一项长期持续性工作，应加强对网络中重点人群的溯源，采取更有效的干预措施减少HIV的传播。

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刘岚铮，E-mail: ；
焦海涛：E-mail:
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黄玉洁（1995—），女，硕士，主管技师，研究方向：艾滋病病毒检测

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黄玉洁（1995—），女，硕士，主管技师，研究方向：艾滋病病毒检测

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黄玉洁（1995—），女，硕士，主管技师，研究方向：艾滋病病毒检测

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Anhui Journal of Preventive Medicine, 2024, 30(1): 34-38., articleTitle=Progress in the prevalence of pretreatment HIV resistant strains inChina, refAbstract=null), Reference(id=1241070002674127562, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035544952631986, doi=null, pmid=null, pmcid=null, year=2021, volume=27, issue=11, pageStart=1212, pageEnd=1217, url=null, language=null, rfNumber=［13］, rfOrder=23, authorNames=孙卓群, 于凤婷, 陈美玲, journalName=中国艾滋病性病, refType=null, unstructuredReference=孙卓群，于凤婷，陈美玲，等．2019-2020年地坛医院HIV-1感染者治疗前耐药及影响因素［J］．中国艾滋病性病, 2021, 27(11): 1212-1217., articleTitle=2019-2020年地坛医院HIV-1感染者治疗前耐药及影响因素, refAbstract=null), Reference(id=1241070002753819340, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035544952631986, doi=null, pmid=null, pmcid=null, year=2021, volume=27, issue=11, pageStart=1212, pageEnd=1217, url=null, language=null, rfNumber=［13］, rfOrder=24, authorNames=Sun ZQ, Yu FT, Chen ML, journalName=Chinese Journal of AIDS & STD, refType=null, unstructuredReference=Sun ZQ, Yu FT, Chen ML, et al. Analysis on the prevalence and influencing factors of pretreatment HIV drug resistance among adults atDitan Hospital in Beijing (2019-2020)［J］. Chinese Journal of AIDS & STD, 2021, 27(11): 1212-1217., articleTitle=Analysis on the prevalence and influencing factors of pretreatment HIV drug resistance among adults atDitan Hospital in Beijing (2019-2020), refAbstract=null), Reference(id=1241070002820928205, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035544952631986, doi=null, pmid=null, pmcid=null, year=2024, volume=35, issue=1, pageStart=49, pageEnd=52, url=null, language=null, rfNumber=［14］, rfOrder=25, authorNames=郭萌, 梅芳华, 刘聪, journalName=公共卫生与预防医学, refType=null, unstructuredReference=郭萌，梅芳华，刘聪，等．2020—2022年湖北省HIV-1感染者治疗前耐药状况分析［J］．公共卫生与预防医学, 2024, 35(1): 49-52., articleTitle=2020—2022年湖北省HIV-1感染者治疗前耐药状况分析, refAbstract=null), Reference(id=1241070002888037070, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035544952631986, doi=null, pmid=null, pmcid=null, year=2024, volume=35, issue=1, pageStart=49, pageEnd=52, url=null, language=null, rfNumber=［14］, rfOrder=26, authorNames=Guo M, Mei FH, Liu C, journalName=Journal of Public Health and Preventive Medicine, refType=null, unstructuredReference=Guo M, Mei FH, Liu C, et al. Primary drug resistance among HIV-1 patients inHubei Province in 2020-2022［J］. Journal of Public Health and Preventive Medicine, 2024, 35(1): 49-52., articleTitle=Primary drug resistance among HIV-1 patients inHubei Province in 2020-2022, refAbstract=null), Reference(id=1241070002963534543, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035544952631986, doi=null, pmid=null, pmcid=null, year=2023, volume=35, issue=6, pageStart=583, pageEnd=589, url=null, language=null, rfNumber=［15］, rfOrder=27, authorNames=谢美榕, 林丽颖, 王征桦, journalName=中国血吸虫病防治杂志, refType=null, unstructuredReference=谢美榕，林丽颖，王征桦，等．2020年福建省新报告HIV-1感染者分子流行特征［J］．中国血吸虫病防治杂志, 2023, 35(6): 583-589., articleTitle=2020年福建省新报告HIV-1感染者分子流行特征, refAbstract=null), Reference(id=1241070003039032016, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035544952631986, doi=null, pmid=null, pmcid=null, year=2023, volume=35, issue=6, pageStart=583, pageEnd=589, url=null, language=null, rfNumber=［15］, rfOrder=28, authorNames=Xie MR, Lin LY, Wang ZH, journalName=Chinese Journal of Schistosomiasis Control, refType=null, unstructuredReference=Xie MR, Lin LY, Wang ZH, et al. Molecular epidemiological characteristics of newly diagnosed HIV-1 cases in Fujian Province in 2020［J］. Chinese Journal of Schistosomiasis Control, 2023, 35(6): 583-589., articleTitle=Molecular epidemiological characteristics of newly diagnosed HIV-1 cases in Fujian Province in 2020, refAbstract=null), Reference(id=1241070003106140881, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035544952631986, doi=null, pmid=null, pmcid=null, year=2022, volume=12, issue=5, pageStart=343, pageEnd=348, url=null, language=null, rfNumber=［16］, rfOrder=29, authorNames=段星, 王妙辰, 王译葵, journalName=中国病毒病杂志, refType=null, unstructuredReference=段星，王妙辰，王译葵，等．德宏傣族景颇族自治州2017—2019年新报告HIV感染者治疗前HIV pol基因耐药突变位点及耐药相关因素分析［J］．中国病毒病杂志, 2022, 12(5): 343-348., articleTitle=德宏傣族景颇族自治州2017—2019年新报告HIV感染者治疗前HIV pol基因耐药突变位点及耐药相关因素分析, refAbstract=null), Reference(id=1241070003198415570, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035544952631986, doi=null, pmid=null, pmcid=null, year=2022, volume=12, issue=5, pageStart=343, pageEnd=348, url=null, language=null, rfNumber=［16］, rfOrder=30, authorNames=Duan X, Wang MC, Wang YK, journalName=Chinese Journal of Viral Diseases, refType=null, unstructuredReference=Duan X, Wang MC, Wang YK, et al. Pre-treatment drug resistance mutations of pol gene and related factors in newly reported HIV/AIDS in Dehong Dai and Jingpo Autonomous Prefecture from 2017 to 2019［J］. Chinese Journal of Viral Diseases, 2022, 12(5): 343-348., articleTitle=Pre-treatment drug resistance mutations of pol gene and related factors in newly reported HIV/AIDS in Dehong Dai and Jingpo Autonomous Prefecture from 2017 to 2019, refAbstract=null), Reference(id=1241070003332633299, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035544952631986, doi=null, pmid=null, pmcid=null, year=2022, volume=28, issue=12, pageStart=1350, pageEnd=1354, url=null, language=null, rfNumber=［17］, rfOrder=31, authorNames=龙海, 甘霖, 杨小燕, journalName=中国艾滋病性病, refType=null, unstructuredReference=龙海，甘霖，杨小燕，等．贵阳市266例新发现HIV/AIDS患者抗病毒治疗前HIV-1耐药及亚型特征［J］．中国艾滋病性病, 2022, 28(12): 1350-1354., articleTitle=贵阳市266例新发现HIV/AIDS患者抗病毒治疗前HIV-1耐药及亚型特征, refAbstract=null), Reference(id=1241070003412325076, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035544952631986, doi=null, pmid=null, pmcid=null, year=2022, volume=28, issue=12, pageStart=1350, pageEnd=1354, url=null, language=null, rfNumber=［17］, rfOrder=32, authorNames=Long H, Gan L, Yang XY, journalName=Chinese Journal of AIDS & STD, refType=null, unstructuredReference=Long H, Gan L, Yang XY, et al. HIV-1 drug resistance and subtype epidemic characteristics of 266 newly confirmed HIV/AIDS patients before antiviral treatment inGuiyang［J］. Chinese Journal of AIDS & STD, 2022, 28(12): 1350-1354., articleTitle=HIV-1 drug resistance and subtype epidemic characteristics of 266 newly confirmed HIV/AIDS patients before antiviral treatment inGuiyang, refAbstract=null)], funds=[Fund(id=1241069999025082980, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035544952631986, awardId=2022-公-03, language=CN, fundingSource=2022年济南市卫生健康委员会公共卫生计划专项项目(2022-公-03), fundOrder=null, country=null), Fund(id=1241069999113163369, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035544952631986, awardId=2023-公-22, language=CN, fundingSource=2023年济南市卫生健康委员会公共卫生计划专项项目(2023-公-22), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1241069990401593546, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035544952631986, xref=1., ext=[AuthorCompanyExt(id=1241069990409982156, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035544952631986, companyId=1241069990401593546, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=Jinan Center for Disease Control and Prevention, Jinan, Shandong 250021, China), AuthorCompanyExt(id=1241069990414176462, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035544952631986, companyId=1241069990401593546, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=1.济南市疾病预防控制中心，山东 济南 250021)]), AuthorCompany(id=1241069990531616985, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035544952631986, xref=2., ext=[AuthorCompanyExt(id=1241069990544199899, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035544952631986, companyId=1241069990531616985, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=2.山东大学齐鲁医学院公共卫生学院)])], figs=[ArticleFig(id=1241069996089070105, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035544952631986, language=EN, label=Fig.1, caption=Phylogenetic tree of newly reported HIV-1 infected MSM in Jinan from 2022 to 2023, figureFileSmall=kipOxAgHLq57BCl77g2beA==, figureFileBig=m3KGEUAdkT4RF75c7TNUWA==, tableContent=null), ArticleFig(id=1241069996189733408, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035544952631986, language=CN, label=图1, caption=2022—2023年济南市新报告HIV-1 MSM感染者系统进化树, figureFileSmall=kipOxAgHLq57BCl77g2beA==, figureFileBig=m3KGEUAdkT4RF75c7TNUWA==, tableContent=null), ArticleFig(id=1241069996311368231, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035544952631986, language=EN, label=Fig.2, caption=Molecular transmission network of newly reported HIV-1 infected MSM in Jinan from 2022 to 2023, figureFileSmall=g//kRb0sqZF0WI2BQo7Z/Q==, figureFileBig=na0ATrUiNh+Lb9BXHrnLHA==, tableContent=null), ArticleFig(id=1241069996449780270, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035544952631986, language=CN, label=图2, caption=2022—2023年济南市新报告HIV-1 MSM感染者亚型分布分子传播网络, figureFileSmall=g//kRb0sqZF0WI2BQo7Z/Q==, figureFileBig=na0ATrUiNh+Lb9BXHrnLHA==, tableContent=null), ArticleFig(id=1241069996592386614, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035544952631986, language=EN, label=Table 1, caption=

Basic characteristicsof newly reported HIV-1 infected MSM in Jinan from 2022 to 2023［n(%)］

, figureFileSmall=null, figureFileBig=null, tableContent=
变量例数2022年2023年
病例数207(100)93(44.9)114(55.1)
民族
汉族203(98.1)92(44.4)111(53.7)
其他4(1.9)1(0.5)3(1.4)
确诊年龄（岁）
15~2444(21.3)18(8.7)26(12.6)
25~3474(35.7)31(15.0)43(20.7)
35~4448(23.2)20(9.7)28(13.5)
45~5432(15.5)17(8.2)15(7.3)
≥559(4.3)7(3.4)2(0.9)
婚姻状况
未婚118(57.0)45(21.7)73(35.3)
已婚或有配偶58(28.0)34(16.4)24(11.6)
离异或丧偶31(15.0)14(6.8)17(8.2)
文化程度
初中及以下43(20.8)20(9.7)23(11.1)
高中及以上163(78.7)72(34.8)91(43.9)
不详1(0.5)1(0.5)0(0.0)
职业
专业技术人员54(26.1)27(13.0)27(13.0)
农民/工人33(15.9)14(6.8)19(9.2)
商业服务52(25.1)24(11.6)28(13.5)
学生21(10.2)6(2.9)15(7.3)
家务及待业29(14.0)19(9.2)10(4.8)
其他18(8.7)3(1.4)15(7.3)
CD4细胞计数（个/μl）
≤20062(30.0)25(12.1)37(17.9)
201~35066(31.9)28(13.5)38(18.4)
351~50037(17.9)20(9.6)17(8.2)
>50032(15.5)15(7.3)17(8.2)
不详10(4.8)5(2.4)5(2.4)
亚型
CRF07_BC76(36.7)36(17.4)40(19.3)
CRF01_AE74(35.7)37(17.9)37(17.9)
CRF114_01559(4.3)3(1.4)6(2.9)
CRF55_01B8(3.9)4(1.9)4(1.9)
B21(10.1)8(3.9)13(6.3)
其他28(13.5)8(3.9)20(9.6)
), ArticleFig(id=1241069998043615800, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035544952631986, language=CN, label=表1, caption=

2022—2023年济南市新报告HIV-1 MSM感染者基本信息［n(%)］

, figureFileSmall=null, figureFileBig=null, tableContent=
变量例数2022年2023年
病例数207(100)93(44.9)114(55.1)
民族
汉族203(98.1)92(44.4)111(53.7)
其他4(1.9)1(0.5)3(1.4)
确诊年龄（岁）
15~2444(21.3)18(8.7)26(12.6)
25~3474(35.7)31(15.0)43(20.7)
35~4448(23.2)20(9.7)28(13.5)
45~5432(15.5)17(8.2)15(7.3)
≥559(4.3)7(3.4)2(0.9)
婚姻状况
未婚118(57.0)45(21.7)73(35.3)
已婚或有配偶58(28.0)34(16.4)24(11.6)
离异或丧偶31(15.0)14(6.8)17(8.2)
文化程度
初中及以下43(20.8)20(9.7)23(11.1)
高中及以上163(78.7)72(34.8)91(43.9)
不详1(0.5)1(0.5)0(0.0)
职业
专业技术人员54(26.1)27(13.0)27(13.0)
农民/工人33(15.9)14(6.8)19(9.2)
商业服务52(25.1)24(11.6)28(13.5)
学生21(10.2)6(2.9)15(7.3)
家务及待业29(14.0)19(9.2)10(4.8)
其他18(8.7)3(1.4)15(7.3)
CD4细胞计数（个/μl）
≤20062(30.0)25(12.1)37(17.9)
201~35066(31.9)28(13.5)38(18.4)
351~50037(17.9)20(9.6)17(8.2)
>50032(15.5)15(7.3)17(8.2)
不详10(4.8)5(2.4)5(2.4)
亚型
CRF07_BC76(36.7)36(17.4)40(19.3)
CRF01_AE74(35.7)37(17.9)37(17.9)
CRF114_01559(4.3)3(1.4)6(2.9)
CRF55_01B8(3.9)4(1.9)4(1.9)
B21(10.1)8(3.9)13(6.3)
其他28(13.5)8(3.9)20(9.6)
), ArticleFig(id=1241069998169444928, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035544952631986, language=EN, label=Table 2, caption=

Main clusters of newly reported HIV-1 infected MSM in Jinan from 2022 to 2023［n(%)］

, figureFileSmall=null, figureFileBig=null, tableContent=
变量C1C2C3C4
节点数9443
确诊时间
20223(33.3)0(0.0)1(75.0)2(66.7)
20236(66.7)4(100.0)3(75.0)1(33.3)
确诊年龄（岁）
15~242(22.2)2(50.0)1(25.0)1(33.3)
25~347(77.8)2(50.0)2(50.0)2(66.7)
35~440(0.0)0(0.0)1(25.0)0(0.0)
婚姻状况
未婚7(77.8)3(75.0)3(75.0)2(66.7)
已婚或有配偶2(22.2)1(25.0)0(0.0)1(33.3)
离异或丧偶0(0.0)0(0.0)1(25.0)0(0.0)
文化程度
中专及以下2(22.2)1(75.0)0(0.0)0(0.0)
大专及以上7(77.8)3(75.0)4(100.0)3(100.0)
CD4细胞计数（个/μl）
≤2002(22.2)0(0.0)0(0.0)0(0.0)
201~3504(44.4)2(50.0)1(25.0)2(66.7)
351~5000(0.0)0(0.0)1(25.0)1(33.3)
>5001(11.1)2(50.0)2(50.0)0(0.0)
不详2(22.2)0(0.0)0(0.0)0(0.0)
), ArticleFig(id=1241069998278496838, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035544952631986, language=CN, label=表2, caption=

2022—2023年济南市新报告HIV-1 MSM感染者重点分子簇分布［n(%)］

, figureFileSmall=null, figureFileBig=null, tableContent=
变量C1C2C3C4
节点数9443
确诊时间
20223(33.3)0(0.0)1(75.0)2(66.7)
20236(66.7)4(100.0)3(75.0)1(33.3)
确诊年龄（岁）
15~242(22.2)2(50.0)1(25.0)1(33.3)
25~347(77.8)2(50.0)2(50.0)2(66.7)
35~440(0.0)0(0.0)1(25.0)0(0.0)
婚姻状况
未婚7(77.8)3(75.0)3(75.0)2(66.7)
已婚或有配偶2(22.2)1(25.0)0(0.0)1(33.3)
离异或丧偶0(0.0)0(0.0)1(25.0)0(0.0)
文化程度
中专及以下2(22.2)1(75.0)0(0.0)0(0.0)
大专及以上7(77.8)3(75.0)4(100.0)3(100.0)
CD4细胞计数（个/μl）
≤2002(22.2)0(0.0)0(0.0)0(0.0)
201~3504(44.4)2(50.0)1(25.0)2(66.7)
351~5000(0.0)0(0.0)1(25.0)1(33.3)
>5001(11.1)2(50.0)2(50.0)0(0.0)
不详2(22.2)0(0.0)0(0.0)0(0.0)
), ArticleFig(id=1241069998383354443, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035544952631986, language=EN, label=Table 3, caption=

Factors related to entering the Molecular transmission network of newly reported HIV-1 infected MSM in Jinan from 2022 to 2023

, figureFileSmall=null, figureFileBig=null, tableContent=
变量总人数
［n(%)］		入网数
［n(%)］		单因素分析多因素分析c
OR值（95% CI）PaOR值（95% CI）P
确诊时间
202293(44.9)22(23.7)1.000--
2023114(55.1)20(17.5)0687(0.348~1.355)0.278--
民族
汉族203(98.1)41(20.2)1.000--
其他4(1.9)1(25.0)1.317(0.134~12.993)0.814--
确诊年龄
15~2444(21.3)14(31.8)1.0001.000
25~3474(35.7)21(28.4)0.849(0.377~1.911)0.6930.824(0.314~2.160)0.694
35~4448(23.2)4(8.3)0.195(0.058~0.650)0.0080.123(0.021~0.724)0.021
45~5432(15.5)1(3.1)0.069(0.009~0.559)0.0120.075(0.006~0.983)0.048
≥559(4.3)2(22.2)0.612(0.112~3.334)0.5700.557(0.057~5.429)0.615
婚姻状况
未婚118(57.0)30(25.4)1.0001.000
已婚或有配偶58(28.0)9(15.5)0.539(0.237~1.227)0.1413.224(0.827~12.566)0.092
离异或丧偶31(15.0)3(9.7)0.314(0.089~1.109)0.0723.212(0.461~22.374)0.239
文化程度
中专及以下80(38.8)7(8.8)1.000 a1.000
大专及以上126(61.2)35(27.8)4.011(1.684~9.554)0.0023.457(1.174~10.181)0.024
基线CD4细胞计数
≤20062(31.5)5(8.1)1.000 b1.000
201~35066(33.5)17(25.8)3.955(1.360~11.504)0.0123.095(0.952~10.062)0.060
351~50037(18.8)9(24.3)3.664(1.122~11.962)0.0312.591(0.698~9.611)0.155
>50032(16.2)9(28.1)4.461(1.349~14.746)0.0144.275(1.128~16.197)0.033
亚型
CRF01_AE74(35.7)16(21.6)1.0001.000
CRF07_BC76(36.7)18(23.7)1.125(0.523~2.419)0.7630.739(0.300~1.820)0.511
CRF55_01B8(3.9)0(0.0)----
B21(10.1)0(0.0)----
其他28(13.5)8(28.6)1.450(0.539~3.899)0.4621.561(0.491~4.970)0.451
), ArticleFig(id=1241069998525960782, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035544952631986, language=CN, label=表3, caption=

2022—2023年济南市新报告HIV-1 MSM感染者入网危险因素分析

, figureFileSmall=null, figureFileBig=null, tableContent=
变量总人数
［n(%)］		入网数
［n(%)］		单因素分析多因素分析c
OR值（95% CI）PaOR值（95% CI）P
确诊时间
202293(44.9)22(23.7)1.000--
2023114(55.1)20(17.5)0687(0.348~1.355)0.278--
民族
汉族203(98.1)41(20.2)1.000--
其他4(1.9)1(25.0)1.317(0.134~12.993)0.814--
确诊年龄
15~2444(21.3)14(31.8)1.0001.000
25~3474(35.7)21(28.4)0.849(0.377~1.911)0.6930.824(0.314~2.160)0.694
35~4448(23.2)4(8.3)0.195(0.058~0.650)0.0080.123(0.021~0.724)0.021
45~5432(15.5)1(3.1)0.069(0.009~0.559)0.0120.075(0.006~0.983)0.048
≥559(4.3)2(22.2)0.612(0.112~3.334)0.5700.557(0.057~5.429)0.615
婚姻状况
未婚118(57.0)30(25.4)1.0001.000
已婚或有配偶58(28.0)9(15.5)0.539(0.237~1.227)0.1413.224(0.827~12.566)0.092
离异或丧偶31(15.0)3(9.7)0.314(0.089~1.109)0.0723.212(0.461~22.374)0.239
文化程度
中专及以下80(38.8)7(8.8)1.000 a1.000
大专及以上126(61.2)35(27.8)4.011(1.684~9.554)0.0023.457(1.174~10.181)0.024
基线CD4细胞计数
≤20062(31.5)5(8.1)1.000 b1.000
201~35066(33.5)17(25.8)3.955(1.360~11.504)0.0123.095(0.952~10.062)0.060
351~50037(18.8)9(24.3)3.664(1.122~11.962)0.0312.591(0.698~9.611)0.155
>50032(16.2)9(28.1)4.461(1.349~14.746)0.0144.275(1.128~16.197)0.033
亚型
CRF01_AE74(35.7)16(21.6)1.0001.000
CRF07_BC76(36.7)18(23.7)1.125(0.523~2.419)0.7630.739(0.300~1.820)0.511
CRF55_01B8(3.9)0(0.0)----
B21(10.1)0(0.0)----
其他28(13.5)8(28.6)1.450(0.539~3.899)0.4621.561(0.491~4.970)0.451
), ArticleFig(id=1241069998639206996, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035544952631986, language=EN, label=Table 4, caption=

Pre-treatment drug resistance mutation sites detected from participants

, figureFileSmall=null, figureFileBig=null, tableContent=
序列PI类耐药突变NRTI类耐药突变NNRTI类耐药突变INSTI类耐药突变亚型
2022-1G190ACRF07_BC
2022-2K65RV106ACRF01_AE
2022-3M41LCRF113_0107
2022-4M46LCRF01_AE
2022-5L74VCRF01_AE
2022-6E138ACRF07_BC
2023-1M184IVCRF07_BC
2023-2M184ICRF01_AE
2023-3M184IVCRF07_BC
2023-4M46LCRF67_01B
2023-5E138KCRF07_BC
), ArticleFig(id=1241069998731481689, tenantId=1146029695717560320, journalId=1227665162245664772, articleId=1241035544952631986, language=CN, label=表4, caption=

研究对象中检出的治疗前耐药突变位点

, figureFileSmall=null, figureFileBig=null, tableContent=
序列PI类耐药突变NRTI类耐药突变NNRTI类耐药突变INSTI类耐药突变亚型
2022-1G190ACRF07_BC
2022-2K65RV106ACRF01_AE
2022-3M41LCRF113_0107
2022-4M46LCRF01_AE
2022-5L74VCRF01_AE
2022-6E138ACRF07_BC
2023-1M184IVCRF07_BC
2023-2M184ICRF01_AE
2023-3M184IVCRF07_BC
2023-4M46LCRF67_01B
2023-5E138KCRF07_BC
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济南市2022—2023年新报告男男性行为人群HIV-1感染者分子传播网络特征分析
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黄玉洁 1 , 林玉玺 2 , 李欣 1 , 潘晶 1 , 韩秀云 1 , 焦海涛 1 , 刘岚铮 1
现代预防医学 | 疾病预防控制 2024,51(24): 4573-4579
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现代预防医学 | 疾病预防控制 2024, 51(24): 4573-4579
济南市2022—2023年新报告男男性行为人群HIV-1感染者分子传播网络特征分析
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黄玉洁1, 林玉玺2, 李欣1, 潘晶1, 韩秀云1, 焦海涛1 , 刘岚铮1
作者信息
  • 1.济南市疾病预防控制中心，山东 济南 250021
  • 2.山东大学齐鲁医学院公共卫生学院

    • 黄玉洁（1995—），女，硕士，主管技师，研究方向：艾滋病病毒检测

通讯作者:

刘岚铮，E-mail: ；
焦海涛：E-mail:
Characteristics of HIV molecular transmission network of men who have sex with men among newly reported HIV cases, Jinan, 2022-2023
Yu-jie HUANG1, Yu-xi LIN2, Xin LI1, Jing PAN1, Xiu-yun HAN1, Hai-tao JIAO1 , Lan-zheng LIU1
Affiliations
  • Jinan Center for Disease Control and Prevention, Jinan, Shandong 250021, China
出版时间: 2024-12-25 doi: 10.20043/j.cnki.MPM.202408384
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摘要
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目的

通过构建济南市新报告男男性行为人群（men who have sex with men, MSM）人类免疫缺陷病毒-1型（human immunodeficiency virus type 1, HIV-1）感染者的分子传播网络，分析传播网络特征，以提高干预效果，减少新发感染。

方法

收集2022—2023年济南市新报告HIV-1 MSM感染者的治疗前样本，采用巢氏PCR方法扩增HIV-1 pol区基因并测序，所得序列构建系统进化树确定亚型，构建分子传播网络并分析入网危险因素，通过美国斯坦福耐药数据库识别并分析耐药突变位点。

结果

本次研究共获得有效序列207条，共发现15种HIV亚型，以CRF07_BC（76例，36.7%）和CRF01_AE（74例，35.7%）为主，其次为B亚型（21例，10.1%），CRF114_0155（9例，4.3%）和CRF55_01B（8例，3.9%）等。选择1.5%为基因距离阈值时，共42条序列入网，入网率为20.3%，形成15个分子簇。Logistic回归分析显示感染者的年龄、文化程度和CD4细胞数与入网相关。多因素分析结果显示，文化程度为大专及以上、CD4计数>500个/μl更容易入网。207例患者样本中有11例存在耐药突变，治疗前耐药率为5.3%，蛋白酶抑制剂（protease inhibitor, PI）耐药突变2例，核苷类逆转录酶抑制剂（nucleotide reverse transcriptase inhibitor, NRTI）耐药突变6例，非核苷类逆转录酶抑制剂（non-nucleoside reverse transcriptase inhibitor, NNRTI）耐药突变2例，整合酶抑制剂（integrase strand transfer inhibitor, INSTI）耐药突变2例，其中有1例患者同时存在NRTI和NNRTI耐药突变。

结论

济南市HIV-1 MSM感染者中基因亚型多样，主要为CRF07_BC和CRF01_AE，年轻且文化程度较高的感染者是传播网络中的活跃人群。HIV分子传播网络监测是一项长期持续性工作，应加强对网络中重点人群的溯源，采取更有效的干预措施减少HIV的传播。

人类免疫缺陷病毒  /  男男性行为人群  /  基因亚型  /  分子网络  /  耐药突变
Objective

To explore the characteristics of HIV molecular transmission network of men who have sex with men (MSM) among newly reported HIV cases in Jinan, China.

Methods

The plasma samples of newly reported HIV-1 MSM in Jinan from 2022 to 2023 were collected. The pol region gene was amplified using nested PCR followed by sequencing. The obtained sequences were used to construct phylogenetic tree and molecular transmission network. The related factors for participants entering a cluster were analyzed. Drug resistance mutations were identified and analyzed using the online software of HIV drug resistance database of Stanford University.

Results

This study obtained 207 sequences and identified 15 HIV-1 subtypes. The dominant subtypes were CRF07_BC (76/207, 36.7%) and CRF01_AE (74/207, 35.7%), followed by B subtypes (21/207, 10.1%), CRF114_0155 (9/207, 4.3%), and CRF55_01B (8/207, 3.9%). Setting 1.5% as the gene distance threshold, a total of 15 molecular clusters were formed by 42 sequences, with a transmission network entry rate of 20.3%. Multivariate Logistic Analysis results showed that MSM with college or above education level and CD4 count>500 cells/μl were more likely to enter the molecular transmission network. Among the 207 participants, 11(5.3%) were detected with drug resistance mutations, including 2 with PI resistance mutations, 6 with NRTI resistance mutations, 2 with NNRTI resistance mutations, and 2 with INSTI resistance mutations. One participant was detected with both NRTI and NNRTI resistance mutations.

Conclusion

The gene subtypes of newly reported HIV cases are diverse, mainly were CRF07_BC and CRF01_AE. MSM with younger age and higher education level are active populations in the HIV transmission network. HIV transmission network monitoring is a long-term and continuous work, and it is necessary to strengthen the traceability of key populations in the network and provide more effective intervention strategies to reduce the HIV transmission.

Human immunodeficiency virus  /  Men who have sex with men  /  Gene subtypes  /  Molecular network  /  Drug resistant mutations
黄玉洁, 林玉玺, 李欣, 潘晶, 韩秀云, 焦海涛, 刘岚铮. 济南市2022—2023年新报告男男性行为人群HIV-1感染者分子传播网络特征分析. 现代预防医学, 2024 , 51 (24) : 4573 -4579 . DOI: 10.20043/j.cnki.MPM.202408384
Yu-jie HUANG, Yu-xi LIN, Xin LI, Jing PAN, Xiu-yun HAN, Hai-tao JIAO, Lan-zheng LIU. Characteristics of HIV molecular transmission network of men who have sex with men among newly reported HIV cases, Jinan, 2022-2023[J]. Modern Preventive Medicine, 2024 , 51 (24) : 4573 -4579 . DOI: 10.20043/j.cnki.MPM.202408384
正文
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HIV感染途径以性传播为主，其中男男性行为人群为HIV感染的高危人群之一，其发病率呈逐年上升趋势[1]。MSM人群多性伴，且多采用无保护性肛交性行为，是HIV感染的重要危险因素[2]。由于HIV感染呈潜伏性，运用传统流行病学方法获取隐私性信息存在困难，使防控难度逐年增大。近年来，利用HIV基因序列进行基于分子网络的传播网络分析在一些发达国家已被列为指导艾滋病防控的新策略，成为揭示HIV传播特征和流行规律的新途径[3]。通过构建分子传播网络，可以发现其中的高风险传播者，及时采取干预措施，对遏制HIV传播和降低新发感染具有重要意义。济南市HIV传播以男男同性性传播为主，本研究选取济南市2022—2023年间新报告的HIV-1感染者中的男男性行为人群为研究对象，通过分析该人群的人口学特征、病毒流行株、分子传播网络特征及耐药突变，了解济南市艾滋病疫情的流行特点，为指导济南市的疫情防控提供科学依据。
1 研究对象与方法
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1.1 研究对象
选取2022—2023年济南市新报告且未经抗病毒治疗的HIV感染者中的MSM人群为研究对象，纳入标准：2022—2023年济南市新报告且未治疗的HIV-1男性感染者，感染途径为同性性传播，签署知情同意书并自愿参与本研究。本研究经山东大学公共卫生伦理委员会批准（编号：伦研批第LL20220906号）。
1.2 方法
1.2.1 病毒核酸提取、扩增及测序
使用EDTA抗凝管采集感染者静脉血，及时离心分离血浆，放置-80℃超低温冰箱冷冻保存。使用天隆科技全自动核酸提取仪及配套试剂盒提取病毒核酸。采用反转录-聚合酶链式反应（Reverse Transcription-Polymerase Chain Reaction，RT-PCR）和巢氏聚合酶链式反应（Nested Polymerase Chain Reaction，nest-PCR）对HIV-1 pol区基因序列进行扩增，扩增的基因片段主要为pol区全部蛋白酶（Protease，PR）基因和部分逆转录酶（Reverse transcriptase，RT）基因（参考毒株HXB2：位置2253-3550nt），试剂盒来自德国QIAGEN公司（OneStep RT-PCR Kit，Taq PCR Master Mix Kit）。扩增产物经1%琼脂糖凝胶电泳鉴定，阳性产物送往北京德弘昌远生物科技有限公司进行后续纯化和测序反应。
1.2.2 确定基因型/重组株
使用BioEdit 7.2.5软件对样本序列和参考序列进行比对，参考序列从国际HIV Database数据库下载。参考《HIV传播网络监测和干预技术指南（试行）》，用于分析的序列需满足以下条件：长度≥1 000个碱基的pol基因序列（PR/RT区），剔除重复序列、污染序列以及混合碱基≥5%的序列。使用FastTree构建系统进化树并确定基因亚型。
1.2.3 构建分子传播网络
将比对好的样本序列导入HyPhy 2.2.4软件，选择TN93模型计算成对基因距离。选取1.5%为基因距离阈值生成传播网络关系，利用Gephi V 0.9.2软件生成可视化分子网络。
1.2.4 耐药性分析
将序列上传至美国斯坦福大学HIV耐药数据库在线软件（https://hivdb.stanford.edu/hivdb/by-sequences/)进行治疗前耐药突变分析。
1.2.5 统计分析
采用SPSS 26.0统计学软件，分类变量用频数和百分比表示，单因素分析采用二元logistic回归分析，将P<0.1的变量纳入多因素分析，采用多因素logistic回归进行多因素分析，检验水准α=0.05，分析研究对象进入分子传播网络的影响因素。
2 结果
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2.1 研究对象基本情况
本次研究成功扩增207例MSM感染者的HIV pol区基因序列，其中2022年93例，2023年114例，感染途径均为男男同性性传播。感染者年龄最小17岁，最大75岁，以25~44岁为主（122例，58.9%）。207例感染者以未婚（118例，57%），高中及以上（163例，78.7%），专业技术人员（54例，26.1%）为主。首次CD4+T细胞计数主要集中在500个/μl以下（165例，79.8%），详见表1。共发现HIV-1基因亚型15种，以CRF01_AE和CRF07_BC为主，分别为74例（35.7%）和76例（36.7%），其次为B亚型（21例，10.1%），其他亚型包括CRF114_0155，CRF55_01B，CRF67_01B等流行重组型和独特重组型，具体亚型分布见图1。
2.2 分子传播网络分析
本次研究选取1.5%为基因距离阈值生成传播网络关系，共42条序列入网，入网率为20.3%，共形成15个分子簇和43条边，最大度数为6，最小度数为1。入网序列的亚型以CRF01_AE和CRF07_BC为主，分别为16例（38.1%）和18例（42.9%），具体亚型分布见图2。所有分子簇中，节点数≥3的传播簇共有4个（C1-C4），详见表2，最大的传播簇C1有9个节点，其中C1和C4为CRF07_BC亚型，C2为CRF104_0107亚型，C3为CRF01_AE亚型。分子簇C1-C4以≤34岁、未婚、学历大专及以上者为主，CD4细胞数主要集中在201~350个/μl之间。
对入网危险因素进行logistic回归分析，单因素分析结果显示，与15~24岁相比，35~44岁（OR=0.195，95% CI：0.058~0.650；P=0.008）和45~54岁（OR=0.069，95% CI：0.009~0.559；P=0.012）入网率较低，与中专及以下相比，大专及以上者（OR=4.011，95% CI：1.684~9.554；P=0.002）更容易入网，CD4细胞计数>200个/μL者比≤200个/μL入网率高，差异有统计学意义（P<0.05）。多因素分析结果显示，文化程度为大专及以上（aOR=3.457，95% CI：1.174~10.181；P=0.024）、CD4计数>500个/μL（aOR=4.275，95% CI：1.128~16.197；P=0.033）入网率高，年龄为35~54岁（aOR=0.123，95% CI：0.021~0.724；P=0.021）和45~54岁者（aOR=0.075，95% CI：0.006~0.983；P=0.048）入网率低，差异有统计学意义（P<0.05），分析结果显示婚姻状况和基因亚型与入网率无明显关联，详见表3。
2.3 耐药突变分析
207例患者样本中有11例存在低度耐药及以上程度的耐药突变，2022年有6例（6.5%，6/93），2023年有5例（4.39%，5/114），总体耐药率为5.3%（11/207），亚型以CRF07_BC和CRF01_AE为主，该11例感染者均未入分子传播网络。耐药突变位点见表4，PI耐药突变2例，突变位点均为M46L；NRTI耐药突变6例，突变位点为K65R、M41L、L74V、M184I、M184IV；NNRTI耐药突变2例，突变位点分别为G190A、V106A；INSTI耐药突变2例，突变位点分别为E138A和E138K。其中有1例同时存在NRTI和NNRTI双重耐药，突变位点为K65R和V106A。
3 讨论
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我国HIV传播途径以性传播为主，每年报告病例经性传播比例均在95%以上[4]。MSM作为HIV传播的高危人群之一，是艾滋病防控工作中的重点。2011年以来，山东省同性性传播感染HIV病例超过异性传播，成为山东省HIV的主要传播途径[5]。有数据显示，济南市2010—2021年HIV感染者/AIDS患者男性占95.17%，感染途径为同性传播者占81.99%[6]。因此，构建济南市MSM感染者的分子传播网络对济南市艾滋病疫情防控具有重要意义。本次研究显示，济南市MSM感染者呈现出年轻化、未婚、高文化程度的特点。此外，MSM感染者中存在部分已婚或有配偶的人群，此人群同时伴有异性性行为，从而造成HIV的异性传播[7]。因此针对此类人群，应做好流调工作，必要时扩大筛检范围。本研究中MSM感染者亚型复杂多样，共有15种，与2021年相比种类增多[8]，以CRF07_BC和CRF01_AE流行株为主，与我国其他地区流行株一致[9-11]。
当基因距离阈值为1.5%时，2022—2023年MSM感染者共纳入42个病例，入网率为20.3%，入网率较低，考虑济南市MSM感染者可能为多点多源传播。所有分子簇中，亚型以CRF01_AE和CRF07_BC为主，有4个传播簇节点数≥3，其中C2簇所有感染者为2023年新报告病例，亚型为CRF104_0107，可作为新发现的分子网络重点关注。所有入网感染者年龄集中在15~34岁，学历为大专及以上。济南高学历青年男性的传播风险高于其他MSM感染者，因此应加强对此类人群的宣传教育，安全套推广和行为干预，同时使感染者尽早纳入抗病毒治疗。
参考世界卫生组织提出的耐药传播的规定,耐药率<5%为低度流行，5%-15%为中度流行[12]，本次研究共发现11例患者存在治疗前耐药突变，耐药率为5.3%，与北京市、湖北省、福建省等地区接近[13-15]。PI类，NRTI类，NNRTI类和INSTI类耐药均存在，耐药突变位点主要有M46L，M184I/V，E138A/K等，是常见的突变位点[16-17]。研究对象存在不同的耐药突变位点，进而导致对治疗药物产生不同程度的耐药，提示临床医生应该基于耐药突变位点检测结果为感染者推荐科学的治疗方案。
本次研究通过对济南市近两年HIV MSM感染者的基本情况、亚型分布、分子传播网络特征和耐药突变进行分析，说明在济南市MSM感染者中HIV传播来源复杂多样，应定期将新诊断的感染者样本进行病毒基因测序，动态监测HIV分子传播网络的变化趋势，对高风险传播者进行流调和干预，提升精准防控的效果。
基金
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  • 2022年济南市卫生健康委员会公共卫生计划专项项目(2022-公-03)
  • 2023年济南市卫生健康委员会公共卫生计划专项项目(2023-公-22)
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2024年第51卷第24期
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doi: 10.20043/j.cnki.MPM.202408384
  • 接收时间：2024-08-26
  • 首发时间：2026-03-18
  • 出版时间：2024-12-25
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  • 收稿日期：2024-08-26
基金
2022年济南市卫生健康委员会公共卫生计划专项项目(2022-公-03)
2023年济南市卫生健康委员会公共卫生计划专项项目(2023-公-22)
作者信息
    1.济南市疾病预防控制中心，山东 济南 250021
    2.山东大学齐鲁医学院公共卫生学院

通讯作者:

刘岚铮，E-mail: ；
焦海涛：E-mail:
参考文献
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https://castjournals.cast.org.cn/joweb/xdyfyx/CN/10.20043/j.cnki.MPM.202408384
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2种不同金属材料的力学参数
科
Family		 属数
Number of
genus		 种数
Number of
species		 占总种数比例
Percentage of
total species (%)		 属
Genus		 种数
Number of
species		 占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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