云南省66例孕产妇的HIV-1基因型和耐药传播水平  

HIV-1genotype and its transmitted drug resistance among pregnant women in Yunnan Province

作　　者：陈敏[1] 贾曼红[1] 王继宝[2] 苏莹珍[1] 杨朝军[1] 杨莉[1] 陈会超[1] 董莉娟[1] 马艳玲[1] 

机构地区：[1]云南省疾病预防控制中心性病艾滋病防制所,云南昆明650022 [2]德宏州疾病预防控制中心艾滋病科,云南芒市678400

出　　处：《中华疾病控制杂志》2014年第12期1199-1202,共4页Chinese Journal of Disease Control & Prevention

基　　金："十二五"国家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(2011ZX10004-903)

摘　　要：目的调查云南省未经抗病毒治疗的人类免疫缺陷病毒(human immunodeficiency virus,HIV)感染孕产妇中的基因型和耐药株传播水平。方法对2010-2012年在云南省德宏州、红河州、临沧市和大理州收集到的66份HIV阳性、且未接受过抗病毒治疗的孕产妇在实施母婴阻断前的血浆样品,进行HIV-1耐药基因型检测和耐药株传播水平分析。结果通过进化分析对pol区进行分型,CRF08_BC是主要的基因型占46.97%(31/66),其他还包括URF(21.21%,14/66)、CRF07_BC(10.61%,7/66)、CRF01_AE(10.61%,7/66)、C亚型(9.09%,6/66)和B亚型(1.52%,1/66)。获得的序列中,2个携带有监测相关的耐药突变(surveillance drug resistance mutations,SDRM),传播性耐药的比例为3.03%(2/66)。1例孕产妇(YNLCPM02)所生的婴儿被诊断为HIV感染,感染率为1.52%(1/66)。结论本次调查的孕产妇中CRF08_BC是主要的基因型,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 HIV-1 genotypes and transmitted drug resistance （TDR） among antiretroviral treatment （ART） -naive HIV-infected pregnant women in Yunnan. Methods 66 plasma samples of untreated HIV-infected pregnant women were collected in Dehong, Honghe, Lincang and Dali Prefectures in Yunnan from 2010 to 2012. HIV-1 genotypes and the prevalent level of HIV-1 drug resistance transmission were analyzed. ResultS： Based on pol sequences, CRF08_BC （ 46. 97 % ） was the predominant subtype, followed by URF （ 21.21% ） , CRF07_BC （ 10. 61% ） , CRF01 AE （ 10. 61% ） , subtype C （9.09%） and subtype B （ 1.52% ）. Among the 66 samples, two strains contained Surveillance Drug Resistance Mutations （SDRM）. The proportion of transmitted drug resistance was 3.03%. One baby born to HIVpositive mother was diagnosed with HIV infection, the infection rate was 1.52%. Conclusions CRF08_BC is the dominant subtype of circulating HIV-1 genotype in the pregnant women investigated, and HIV-1 drug resistance is still catalogued as a low prevalence level among untreated HIV-infected pregnant women in Yunnan Province. To prevent the increase of the prevalence of transmitted HIV-1 drug resistance, on the base of strengthening HIV prevention and control in the key population, the standard treatment and scientific management to AIDS patients should be improved, and the drug resistance surveillance should be oerformed oeriodicallv.

关 键 词：HIV 基因型 抗病毒药物 

分 类 号：R512.91[医药卫生—内科学]