2013年上海市男男性接触人群人类免疫缺陷病毒-1毒株耐药基因的变异  

Gene mutations of human immunodeficiency virus drug resistance from men who have sex with men in Shanghai, 2013

作　　者：吴健[1] 王绪琴[2] 尹鹤峰[1] 袁家麟[1] 郁晓磊 周艳秋[3] 郑敏[4] 盖晶[2] 陶静[5] 薛以乐[2] 康来仪[2] 

机构地区：[1]上海市黄浦区疾病预防控制中心性病艾滋病麻风病防治科,200023 [2]上海市疾病预防控制中心性病艾滋病麻风病防治科 [3]上海市静安区疾病预防控制中心性病艾滋病麻风病防治科 [4]上海市长宁区疾病预防控制中心性病艾滋病麻风病防治科 [5]上海市虹口区疾病预防控制中心微生物检验科

出　　处：《中华传染病杂志》2016年第1期23-26,共4页Chinese Journal of Infectious Diseases

摘　　要：目的了解上海市新发现未经抗病毒治疗的MSM人群HIV-1毒株耐药基因变异情况，为优化防控方案提供科学依据。方法对2013年新发现的未经抗病毒治疗的所有MSM人群中的HIV感染者，共669份血浆标本，进行反转录PCR扩增、DNA测序、亚型鉴定，并与国际HIV耐药数据库比对分析。结果最后获得645份pol区基因片段，原发耐药率为2．48％（16／645）；其中核苷类反转录酶抑制剂（NRTI）耐药相关突变率为0．16％（1／645），非核苷类反转录酶抑制剂（NNRTI）耐药相关突变率为1．70％（11／645），NRTI和NNRTI同时耐药相关突变率为0．31％（2／645），蛋白酶抑制剂（PI）耐药相关突变率为0．31％（2／645）。亚型重组CRF01-AE中耐药突变率为2．99％（12／401）；CRF07-BC中NNRTI耐药突变率为0．61％（1／163）；CRF-01B中NNRTI耐药突变率为4．65％（2／43），分别为CRF52—01B和未定型CRF01B各1份；欧美B亚型中NNRTI耐药突变率为2．70％（1／37）。结论2013年上海市MSM人群HIV-1感染者耐药株的流行仍处于低水平，其中NNRTI耐药相对较高，基因型以CRFO1—AE耐药为主，今后需进～步加强对该人群的耐药监测。Objective To investigate the gene mutations of human immunodeficiency virus （HIV）-I drug resistance among anti-retrovirus （ARV） treated-naive men who have sex with men （MSM） in Shanghai to provide evidence-based data for optimized treatment. Methods All 669 treatment-naive cases of HIV-1 infection identified among MSM in 2013 were recruited and their plasma was collected. RNA was extracted and amplified by nest reverse transcription-polymerase chain reaction, and DNA was sequenced and then phylogenetically analyzed. Finally, subtypes were identified and drug resistance was analyzed in comparison with International HIV Drug Resistance Database. Results The pol gene fragments of 645 cases were obtained. Primary drug-resistance rate was 2.48% （16/645）, including mutations conferring resistance to protease inhibitor （PI） （0.31%, 2/645）, nucleoside reverse transcriptase inhibitors （NRTI） （0.16 %, 1/645）, non-nucleoside reverse transcriptase inhibitors （NNRTI） （1.70 %, 11/645） and both NRTI and NNRTI （0. 31 %, 2/645）, respectively. Mutations conferring resistance to CRF01_AE were 12 cases （2. 99%）, while mutations conferring resistance to CRF07_BC and CRF_01B were O. 61% （1/163） and 4.65% （2/43） including 1 case of CRF52_01B and unidentified CRF 01B, respectively. Resistance to NNRTI in B subtype were 2. 70% （1/37）. Conclusion The prevalence of HIV-1 drug resistance-associated mutations among MSM in Shanghai, 2013 is still low, but resistance to NNRTI is relatively high. CRF01 AE is the major subtype of drug resistance. It is necessary to strengthen the HIV drug resistance surveillance in MSM group in Shanghai.

关 键 词：人类免疫缺陷病毒-1 同性恋 男性 亚型/重组体 抗药性 

分 类 号：R512.91[医药卫生—内科学]