云南省临沧市2012年HIV-1基因型和耐药传播警戒线调查  

HIV-1 genetics and drug resistance threshold survey in Lincang City of Yunnan Province in 2012

作　　者：陈敏[1] 苏莹珍[1] 杨朝军[1] 董莉娟[1] 杨莉[1] 施玉华[1] 陈会超[1] 罗红兵[1] 贾曼红[1] 马艳玲[1] 

机构地区：[1]云南省疾病预防控制中心,昆明650022

出　　处：《中国艾滋病性病》2013年第10期722-725,共4页Chinese Journal of Aids & STD

基　　金：国家"十二五"科技重大专项"云南省防治艾滋病规模化现场流行病学"课题(项目编号2011ZX10004-903)~~

摘　　要：目的了解2012年临沧市未经抗病毒治疗的艾滋病病毒Ⅰ型(HIV-1)感染者中,病毒的基因型分布和耐药株传播水平。方法根据HIV-1耐药警戒线调查实施方案,对2012年2-7月,临沧市符合方案要求的50份年龄在18-25岁的、新发现的HIV-1感染者的血浆样本,进行耐药基因型检测和耐药株传播水平分析。结果 50份血浆样本中,36份完成了基因型及耐药鉴定。通过进化分析对pol区进行分型,75.0%(27/36)的样本为CRF08_BC,其他依次为URF_BC(8.3%,3/36)、CRF07_BC(5.6%,2/36)、CRF01_AE(5.6%,2/36)和C亚型(5.6%,2/36)。URF_BC重组中有两例重组模式相同。获得的序列中未检测到监测相关的耐药突变(Surveillance drug resistance mutations,SDRM),按照耐药警戒线的统计方法估算,耐药株流行率<5%。结论临沧市目前主要流行的HIV-1亚型为CRF08_BC,HIV-1耐药株处于低度流行水平。为控制耐药传播水平的上升,在加强重点人群艾滋病防治的基础上,应加强规范艾滋病抗病毒治疗及科学管理,同时有计划地开展相关的耐药监测。Objective To study the human immunodeficiency virus 1 （HIV-1） genotypes and transmitted drug resistance （TDR） before antiretroviral therapy in Lincang City of Yunnan province in 2012. Methods According to the guidelines for HIV drug resistance threshold survey （HIVDR-TS）, 50 plasma samples of recently reported HIV- infected individuals between 18 and 25 years old were collected in Lincang City from February to July 2012. Genoty- ping of partial pol gene was performed by using reverse transcriptional PCR, HIV-1 subtype and the prevalent levels of HIV-1 drug resistance transmission was analyzed. Results 36 plasma samples were successfully sequenced. Based on pol sequences, identified HIV genotypes included CRF08_BC （75.0%, 27/36）, URF_BC （8.3%, 3/36）, CRF07_BC （5.6G, 2/36）, CRF01_AE （5.6%, 2/36） and subtypeC （5.6%, 2/36）. Among URF BC recombi- nants, two shared the same recombination pattern. Among the 36 sequenced samples, no Surveillance Drug Resist- ance Mutations （SDRM） has been detected. Based on the statistical method of WHO HIV drug resistance threshold survey, the prevalence of transmitted HIV-1 drug resistance was adjusted as 〈5%. Conclusion CRF08_BC is the predominant circulating HIV-1 subtype in Lincang, and the current HIV-1 drug resistant strains transmission is still catalogued as at a low prevalence level in Lincang. To prevent the increase of the prevalence of transmitted HIV-1 drug resistance, HIV prevention and control in the target population should be strengthened. Meanwhile, perform- ing drug resistance surveillance periodically is as important as standard treatment and scientific management to AIDS patients.

关 键 词：艾滋病病毒I型 基因型 耐药警戒线调查 抗病毒治疗 

分 类 号：R373.9[医药卫生—病原生物学]