中国MSM人群中HIV-1亚型与不同位点耐药突变发生频率的Meta分析  

The frequency of drug resistance mutations among different HIV-1 subtypes in Chinese MSM: a Meta-analysis

作　　者：殷玥琪 朱靖[1] 吴楠楠[1] 汪清[1] 洪翔[1] 王蓓[1] 

机构地区：[1]东南大学公共卫生学院流行病学与卫生统计学系,流行病学教研室,江苏南京210009

出　　处：《中华疾病控制杂志》2017年第6期622-626,共5页Chinese Journal of Disease Control & Prevention

基　　金：高等学校博士学科点专项科研基金(20130092110048)

摘　　要：目的了解我国男男性行为(men who have sex with men,MSM)人群中人类获得性免疫缺陷病毒1型(human immunodeficiency virus type 1,HIV-1)亚型与不同耐药位点突变发生频率的情况。方法检索CNKI、CBM、万方、Pub Med、Web of science、Embase等数据库,收集有关中国MSM人群HIV-1亚型与耐药基因突变的现况调查研究,采用系统评价的方法严格筛选文献,以美国医疗保健研究与质量局(the agency for healthcare research and quality,AHRQ)质量评价条目评价文献质量,对所提取数据采用Freeman-Tukey双反正弦变换法计算各位点合并的耐药突变发生频率,以不同亚型为分组进行亚组分析,采用Begg’s test估计发表偏倚,统计分析由Stata 12.0软件完成。结果共纳入10篇研究文献,获得耐药突变位点信息23个,包含亚型五种(01AE、07BC、08BC、B、URFs)。突变发生频率超过5%的位点有:A71T/V/I 17.42%(8.20~29.17),V179D/E 11.06%(6.24~17.00),Y181C/N11.95%(0.50~35.28),L10I/V 7.06%(4.14~10.65),K103N 5.67%(1.75~11.66)。M46I/L、T69D/NS、L74I/S与K103N/R的突变仅在01AE亚型中检测到,B亚型检测出发生突变的位点其突变发生频率均高于其他亚型。结论我国MSM感染者中01AE亚型携带更多种类的耐药突变相关位点,B亚型耐药相关位点的突变频率更高,上述两种亚型及其耐药突变对传播耐药发生率的贡献度大,需要加强防治。Objective To understand the frequency of HIV-1 drug resistance mutation and the distribution among different subtypes in Chinese MSM. Methods A computerized literature search was carried out in Chinese Journal Fulltext Database（CNKI） , Wanfang Database, SinoMed Database, Pubmed, web of science, Embase, etc. Related papers were collected to identify screening studies for HIV-1 drug resistance mutations in China. Systemic review was performed to filter qualified studies, which must have definite study time, locations, criterion of drug resistance test and other related information. The data extracted from the included studies were calculated by Freeman-Tukey method to acquire the combine rate. Subgroup analysis was executed by HIV-1 subtypes. Begg＇ s test was executed to test publication bias. All the statistical analysis were performed by Stata 12.0 software. Results Ten studies were included, the information of 23 mutation sites were obtained, five subtypes （01AE, 07BC, 08BC, B, CRFs） were. The prevalence of A71T/V/I was 17.42% （8.20-29.17）. Mutation sites M46I/L, T69D/NS, L74I/S and KIO3N/R were only tested in subtype 01AE. The prevalence of mutation rate of each mutation site in subtype B was higher than other subtypes. Conclusions In Chinese MSM, mutation of HIV-1 in subtype 01AE is diversification and the mutation rate among different sites on subtype B are higher than other subtypes. Subtypes of 01AE and B in transmission drug resistance contribute more than others, which need more attention.

关 键 词：人免疫缺陷病毒1型 突变 META分析 

分 类 号：R181.2[医药卫生—流行病学] R183[医药卫生—公共卫生与预防医学]