广东男男性行为HIV-1感染者中耐药情况及基因型分布  

Investigation of HIV-1 drug resistance and gene subtype prevalence in man have sex with man in Guangdong province

作　　者：于国龙[1] 秦冰 鄢心革[1] 刁丽梅[1] 李杰[1] 周平平 颜瑾[1] 李艳[1] 杨放[1] 林鹏[1] 

机构地区：[1]广东省疾病预防控制中心艾滋病预防控制所,广东广州510300 [2]广东省生物制品与药物研究所预防药物研究室,广东广州510440 [3]广东省公共卫生研究院中心实验室,广东广州511430

出　　处：《分子诊断与治疗杂志》2015年第3期156-160,198,共6页Journal of Molecular Diagnostics and Therapy

基　　金："十二五"重大科技专项(2012ZX10004902);广东省医学科研基金(WSTJJ2014A088)

摘　　要：目的了解2013年在广东省新发现的男男性行为（man have sex with man,MSM）人类免疫缺陷病毒-Ⅰ（human immunodeficiency virus 1,HIV-1）感染者中基因型耐药情况及亚型分布。方法采用In-House方法,扩增HIV-1 pol基因蛋白酶区（protease region,PR）基因全长和逆转录酶区（reverse transcriptase region,RT）基因部分片段,通过HIV-1耐药数据库,获得个体耐药突变位点、基因亚型及药物耐受情况。结果在203人中,HIV-1病毒载量拷贝数中值为4.27×10~4拷贝/mL,平均值拷贝数为9.37×10~4拷贝/mL;高度基因型耐药病例2人,占1.2%;中度耐药1人,占0.6%;低度耐药7人,占4.1%;潜在耐药26人,占15.4%。PR区未见主要耐药突变;RT区主要耐药突变有：K70R、M184V、T215IT、K219E、K103KN、V106I、E138EG、V179E/D;出现了针对核苷类逆转录酶抑制剂3TC及FTC的高度耐药1例,占0.6%;针对非核苷类逆转录酶抑制剂EFV及NVP高度耐药1例,占0.6%;亚型方面,主要以CRF01_AE及CRF_BC重组亚型为主,同时B亚型在MSM人群中占20.1%。结论广东省目前MSM感染者中HIV-1高度耐药毒株尚处于低流行,潜在耐药毒株可能已经在人群中传播;MSM人群中以CRF01_AE、CRF_BC重组亚型及B亚型毒株流行为主。Objective To estimate the drug resistance and subtype distribution among human im- munodeficiency virus l（HIV-1）-infecters（man have sex with man, MSM） in Guangdong province in 2013. Methods The full length of HIV-1 protease gene and part of reverse transcriptase gene were amplified with the In-house method. The obtained sequences were blasted with the stanford HIV-1 drug resistance database to get the drug resistance mutations, gene subtypes and drug resistance. Results In 203 patients, the median viral load was 4.27 × 10^4 copies/mL, and the average value was 9.36 × 10^4 copies/mL. It was showed that 2 individuals （1.2%） were highly resistant, 1 individual （0.6%） was intermediate resistant, 7 individuals （4.1%） were with low level of resistance, and 26 individuals （15.4%） were with potential low level of resistance. No major resistance mutation was found in protease region （PR）. The major drag resistance mutations in reverse transcriptase region （RT） were K70R, M184V, T215IT, K219E, K103KN, V106I, E138EG and V179E/D. One high drug resistance to 3TC and FTC was found in nucleoside reverse transcriptase inhibitor （NRTI）, and one high drug resistance to NVP and EFV was found in non-nucleoside reverse transcriptase inhibitor （NNRTI）. The high drug resistance in NRTI and NNRTI was 0.6% and 0.6%, respectively. The CRF_01AE was the main subtype among the MSM population, which was followed by CRF_BC, and the proportion of B subtype in MSM population was 20.1%. Conclusion Although the HIV-1 strains with high resistance level are now prevailing at a low level, the potential resistance viral strains might have been prevailing among MSM population. And the CRF01_AE, CRF_BC and B subtype are the prevalent HIV-1 subtypes among the MSM population.

关 键 词：男男性行为 高效抗逆转录病毒治疗 HIV-1耐药 

分 类 号：R512.91[医药卫生—内科学]