浦东新区MSM HIV-1分子流行病学的研究  

HIV-1 molecular epidemiology among MSM in Pudong New Area of Shanghai city

作　　者：汤琰[1] 孙乔[1] 薛以乐[2] 赵希畅[1] 蒋培华[1] 张鹏[1] 张枭[1] 金樱枝[1] 曹志钦[1] 

机构地区：[1]上海市浦东新区疾病预防控制中心,上海200136 [2]上海市疾病预防控制中心,上海200336

出　　处：《中国艾滋病性病》2015年第6期461-465,共5页Chinese Journal of Aids & STD

基　　金：国家"十二五"艾滋病和病毒性肝炎等重大传染病防治重大科技专项(2012ZX10004201)~~

摘　　要：目的了解上海市浦东新区近年来男男性行为人群(MSM)中,未经抗病毒治疗的艾滋病病毒1型(HIV-1)抗体阳性者,其HIV-1亚型分布和原发性耐药特征,监测该地区MSM HIV-1毒株的最新流行情况,为当前该区制定艾滋病防治策略提供科学依据。方法选取2011年至2014年4月份期间确认的MSM HIV-1感染者血浆标本70份,应用巢式反转录聚合酶链反应(RT-PCR)扩增pol基因,并对扩增产物进行测序,用Mega 6.0软件将测序结果与各亚型国际参考株比对,根据系统进化树分析确定基因亚型及其特征以及耐药情况。结果获62份pol区基因全序列片段,得到CRF01-AE、CRF07_BC、01B(CRF01_AE与B重组亚型)和B四种亚型。分布显示:CRF01-AE占58.06%(36/62),CRF07_BC占30.65%(19/62),01B占6.45%(4/62),B占4.84%(3/62)。离散率显示:CRF01-AE亚型的平均离散率为(2.1±0.2)%(n=36),CRF07-BC亚型的平均离散率也为(2.1±0.2)%(n=19),B亚型的平均离散率为(5.7±0.6)%(n=3),01B重组亚型的平均离散率为(6.3±.0.6)%(n=4)。耐药特征:62例中有7例分别产生了对核苷类反转录酶抑制剂(NRTIs)、非核苷类反转录酶抑制剂(NNRTIs)及蛋白酶类抑制剂(PIs)的耐药突变,其中2例产生了低度耐药,4例具有潜在的耐药特点。结论上海市浦东新区2011年至2014年4月间,MSM新确证HIV-1感染者中,基因亚型呈多元化趋势,以CRF01-AE和CRF07-BC为主,并已形成了浦东新区范围内的局部流行趋势,新的01B重组毒株已在浦东新区开始出现;HIV-1原发耐药株的传播尚处于低度流行水平,密切监视其流行趋势已显十分必要。Objective To understand the men who have sex with men （MSM） in Pudong New Area of Shanghai city in recent years, the human immunodeficiency virus （HIV） -1 positive persons without antiviral therapy of HIV- 1 subtype distribution and primary drug resistance characteristics, the epidemic monitoring of HIV-1 strains among MSM population in the region, and provide scientific basis for the formulation of the current district AIDS preven- tion strategies. Methods Plasma specimens of 70 MSM with HIV-1 infection confirmed from 2011 to April 2014 were collected, nested reverse transcription polymerase chain reaction （Nested reverse transcription-polymerase chain reaction, Nested RT-PCR） was used to amplify pol gene, and the amplified products were sequenced, the se- quencing results were compared with the international reference strains of different subtypes by using Mega 6 soft- ware, the genotypes and drug resistance characteristics were confirmed by the phylogenetic tree. Results Subtype distribution among the pol gene fragments showed thant four kinds of subtypes composed of CRF01-AE, CRF07 BC, 01B（recombinant subtypes of CRF01_AE and B）, B were included, and CRF01-AE accounted for 58.06%（36/ 62）, CRF07-BC accounted for 30.64% （19/62）, 01B accounted for 6. 45% （4/62）, B accounted for 4.84% （3/62）. The average discrete rate of subtype CRF01-AE was （2.1±0.2）%（n=36）, the average discrete rate of subtype CRF07-BC was （2.1±0.2） M（n=19）, the average discrete rate of subtype B was （5.7±0.6）%（n = 3）, the average discrete rate o{ subtype 01B was（6.3 ± 0.6） %（n = 4）. About resistance characteristics, drug-resistant mutations were found in 7 of 62 cases, including nucleoside reverse transcriptase inhibitors in 62 cases （NRTIs） and non nueleoside reverse tran-scriptase inhibitors （NNRTIs） and protease inhibitors （PIs） of drug resistant mutations, respectively; of which 2 cases had low drug resistance and 4 cases had potentially resistant characteristi

关 键 词：艾滋病病毒1型 基因亚型 男男性行为人群 原发耐药 

分 类 号：R373.9[医药卫生—病原生物学]