云南省德宏州2013年HIV-1耐药毒株传播警戒线调查结果分析  

Analysis on HIV-1 genetics and threshold of drug resistance in Dehong prefecture of Yunnan province in 2013

作　　者：马艳玲[1] 王继宝[2] 邢辉[3] 陈敏[1] 姚仕堂[1] 陈会超[1] 杨锦[2] 李艳玲[2] 段松[2] 贾曼红[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,昆明650022 [2]德宏州疾病预防控制中心 [3]中国疾病预防控制中心性病艾滋病预防控制中心

出　　处：《中华流行病学杂志》2015年第6期584-588,共5页Chinese Journal of Epidemiology

摘　　要：目的 调查2013年云南省德宏州未经抗病毒治疗的HIV-1感染者的基因型分布和耐药毒株传播水平.方法 根据HIV耐药警戒线调查实施方案,对2013年1-8月德宏州符合要求的54份年龄在16 - 25岁,新发现的HIV-1感染者的血浆样本进行HIV-1基因型检测和耐药毒株传播水平分析.结果 48份样本完成了基因型及耐药鉴定,中国籍占45.8％,缅甸籍占54.2％.通过进化分析对pol区进行分型,主要的基因型包括：C亚型（41.7％）、URF（31.3％）、CRF01 AE（12.5％）、CRF07 BC（10.4％）、CRF08 BC（2.1％）和B亚型（2.1％）.中国籍感染者中首位的基因型是C亚型,而外籍感染者中首位的基因型是URF.在1份缅甸籍样本序列中检测到1个针对非核苷类反转录酶抑制剂类药物的耐药突变位点（K103N）,按照耐药警戒线的统计方法估算耐药毒株流行率为＜5％.结论 本次调查提示德宏州新报告的HIV-1感染者中存在复杂的基因型,HIV-1耐药毒株处于低度流行水平.为控制耐药传播水平的上升,应进一步规范本地艾滋病抗病毒治疗及管理,并针对跨境传播开展包括耐药传播在内的相关监测。Objective To study the HIV-1 genotypes and transmitted drug resistance （TDR） in Dehong prefecture of Yunnan province in 2013.Methods Referring to the guidelines for HIV drug resistance threshold survey （HIVDR-TS）,54 plasma samples of recently reported HIV-infected individuals,aged between 16 and 25 years,were collected in Dehong prefecture from January to August 2013.Genotyping of partial pol gene was performed by using reverse transcriptional PCR.HIV-1 genotype.Prevalent levels of HIV-1 drug resistance transmission were analyzed.Results Forty-eight plasma samples were successfully sequenced and analyzed.Among them,45.8% were Chinese and the rest 54.2% were all Burmese.Based on pol sequences,identified HIV genotypes included subtype C （41.7%）,URF （31.3%）,CRF0 1_AE （12.5%）,CRF07_BC （10.4%）,CRF08_BC （2.1%） and subtype B （2.1%）,C subtype appeared dominated in Chinese while URF was dominated in Burmese.One drug resistant mutation to non-nucleoside reverse transcriptase inhibitors （NNRTIs） was detected in one sequence from Burmese.Based on the statistical method of HIVDR-TS,the prevalence of transmitted HIV-1 drug resistance was adjusted as 〈5%.Conclusion Diverse HIV-1 genotypes were found in this study,and the current HIV-1 drug resistant strains transmission was catalogued as at low prevalence level,in Dehong.To prevent the increase of the prevalence of transmitted HIV-1 drug resistance,standard treatment and scientific management for people living with HIV/AIDS should be strictly followed.Meanwhile,relevant surveillance,including drug resistance surveillance should also be performed among cross-border migrant population.

关 键 词：艾滋病病毒 基因型 耐药警戒线 抗病毒治疗 德宏州 

分 类 号：R512.91[医药卫生—内科学]