石家庄市2015年新确诊HIV-1感染者流行毒株的亚型分布及原发性耐药分析  

Genetic characteristics and primary drug resistance of HIV-1 among newly-diagnosed HIV-infected individuals in Shijiazhuang city of Hebei province in 2015

作　　者：王险峰[1,2] 李峰 刘晓松[1] 周红[1] 李洁芳[1] 刘丽花[1] 刘淑君[1] 汪宁[2] 

机构地区：[1]石家庄市疾病预防控制中心,石家庄050000 [2]中国疾病预防控制中心性病艾滋病预防控制中心,北京102206

出　　处：《中国艾滋病性病》2018年第2期120-124,共5页Chinese Journal of Aids & STD

基　　金：国家科技重大专项(2012ZX10001-001);河北省卫生计生委科研项目(20160805)~~

摘　　要：目的了解河北省石家庄市2015年新确诊1型艾滋病病毒（HIV-1）流行毒株的亚型分布和原发性耐药情况。方法 2015年石家庄市新报告HIV-1感染者433例,共收集到感染者血浆样本335份,经反转录巢式荧光定量聚合酶链反应（RT-PCR）方法扩增,最终获得311份样本的HIV-1 pol基因片段并测序。对获得的核酸序列用Neighbor.Joining Tree方法构建进化树,以Boot strap值〉70%来判定HIV-1的基因亚型。同时将序列提交至美国斯坦福大学HIV耐药数据库进行耐药基因型分析。结果 311例HIV-1感染者以男性（93.9%）、本市户籍（83.0%）、汉族（96.1%）为主。性接触是最主要的感染途径（98.1%）,其中同性性传播占77.5%。311例pol基因序列片段亚型分布显示,CRF01_AE占51.4%（160例）,CRF07_BC为28.6%（89例）,B亚型为13.2%（41例）,未定型CRF01_B为4.2%（13例）,CRF08_BC为1.3%（4例）,CRF55_01B为0.6%（2例）,CRF59_01B为0.3%（1例）,CRF65_cpx为0.3%（1例）和CRF01_AE/B为4.2%（13例）。CRF01_AE、CRF07_BC和B是主要的亚型。HIV-1基因亚型分布在性别之间（χ~2=14.039,P=0.005）、不同的职业类型之间（χ~2=21.716,P=0.041）以及不同的传播途径之间（χ~2=20.971,P=0.028）有统计学差异。311例中,14例感染者具有耐药位点,原发耐药率为4.5%,其中蛋白酶抑制剂和核苷类反转录酶抑制剂耐药相关突变率均为1.6%（各5例）,非核苷类反转录酶抑制剂耐药相关突变率为1.3%（4例）。结论石家庄市新报告的HIV-1感染者中,传播途径以同性性接触为主,病毒基因亚型以CRF01_AE为主,但具有多样化特点。原发耐药率为4.5%,处于低水平状态。Objective To better understand the distribution of gene subtypes and the situation of drug resistance among newly-diagnosed HIV-1 infected individuals in Shijiazhuang city in 2015.Methods A total of 335 newly HIV-1 diagnosed subjects were recruited.Nucleotide sequences of 1.1-kb pol region were amplified and sequenced from 311 of the 335 samples.Phylogenetic,evolutionary and genotypic drug resistance analyses were performed.Results Of all subjects,the majority were male（93.9% ）and MSM（77.5% ）.96.1% individuals in this study were Han ethnicity and 82.7% were permanent residents in Shijiazhuang.The overall distribution of HIV-1 genotypes was as the following：CRF01_AE,51.4% ;CRF07_BC, 28.6% ; subtype B 13.2% ; 01/B recombinants,4.2% ;CRF08_BC,1.3% ;CRF55_01 B0.6% ;CRF59_01 B0.3% and CRF65_cpx 0.3% .CRF01_AE,CRF07_BC and B were the predominant strains.The difference of distribution in gene subtypes was significant in the gender groups（χ~2=14.039,P=0.005）,category of employment（χ~2=21.716,P=0.041）and route of transmission（χ~2=20.971,P=0.028）,respectively.The prevalence rate of primary drug-resistance was 4.5% .The mutation associated drug resistant rates to protease inhibitors（PIs）,nucleoside reverse transcriptase inhibitors（NRTIs）and non-nucleoside reverse transcriptase inhibitors（NNRTIs）were 1.6% （5/311）,1.6% （5/311）and 1.3% （4/311）,respectively.Conclusion Homosexual contact is the main mode among newly HIV-1 diagnosed individuals in Shijiazhuang city in 2015.Gene subtypes have the characteristics of diversification and CRF01_AE is the predominant strain.It is necessary to strengthen drug resistance monitoring in new diagnosed populations.

关 键 词：I型艾滋病病毒(HIV-1) 男男性行为者 基因亚型 重组体 原发性耐药 

分 类 号：R512.91[医药卫生—内科学] R373.9[医药卫生—临床医学]