2011-2013年深圳市新报告男男性行为传播的HIV-1感染者原发性耐药及相关因素  

A survey on drug resistance and related factors in antiretroviral-naive HIV-1 new reported infection among men who have sex with men in Shenzhen,2011-2013

作　　者：吕星[1] 郑成丽 刘少础[1] 张燕[1] 谢炜[1] 陈琳[1] 谭唯[1] 卫兰 赵锦[1] LYU Xing;ZHENG Chenli;LIU Shaochu;ZHANG Yan;XIE Wei;CHEN Lin;TAN Wei;WEI Lan;ZHAO Jin(Shenzhen Center for Disease Control and Prevention,Shenzhen 518020,Guangdong,China)

机构地区：[1]深圳市疾病预防控制中心,广东深圳518000

出　　处：《中国艾滋病性病》2019年第12期1242-1245,1253,共5页Chinese Journal of Aids & STD

基　　金：国家自然科学基金项目(81573211);深圳市卫生计生系统科研项目(SZGW2017006);深圳市医疗卫生三名工程(SZSM201811071)。

摘　　要：目的分析深圳市新报告的男男性行为传播的1型艾滋病病毒(HIV-1)抗体阳性者治疗前耐药的相关因素,为临床抗病毒治疗(ART)方案提供科学依据。方法选取2011-2013年在深圳地区首次确证的、男男性行为传播感染的、HIV-1抗体阳性未接受ART者,分析原发性耐药与亚型、年龄等指标之间的关系。结果纳入本次研究的1046例样本中,原发性耐药率为4.40%(46例),传播耐药率为1.43%(15例)。蛋白酶抑制剂相关耐药发生率为1.43%(15例),核苷类反转录酶抑制剂相关耐药发生率为0.76%(8例),非核苷类反转录酶抑制剂相关耐药发生率为2.49%(26例)。CRF5501B、CRF01AE、CRF07BC和B的原发性耐药率分别为9.43%、3.10%、3.24%和8.77%(P=0.002)。2011-2013年的原发性耐药率分别为2.44%、4.02%、5.40%(P=0.256)。三个年龄组(≤24岁、25~34岁、≥35岁)的原发性耐药率分别为2.41%、4.90%和6.12%(P=0.066)。结论2011-2013年深圳市新报告男男性行为传播的HIV-1感染者原发性耐药率处于低水平,不同年龄组之间的原发性耐药率无显著性差异,CRF5501B的原发性耐药率显著性高于其他亚型。应对CRF5501B的耐药情况持续密切监测和分析评估。Objective To analyze the prevalence of drug resistance and relevant factors in antiretroviral-naive HIV-1 new reported infection among men who have sex with men in Shenzhen,and provide basis for optimization of anti-retroviral therapy(ART).Methods The plasma specimens were collected from newly diagnosed and antiretroviral-naive HIV-1 infected MSM in Shenzhen from 2011 to 2013.The HIV-1 pol gene fragment was sequenced.After the new infection samples screened,the primary drug resistance rate and transmitted drug resistance rate were calculated.The differences in drug resistance rates between years,subtypes and age groups were analyzed.Results A total of 1046 samples were included in the study.The prevalence of primary drug-resistance was 4.40%(46),and the prevalence of TDR was 1.43%(15).Mutations associated with resistance to PI,NRTI and NNRTI were 1.43%(15),0.76%(8/1046),and 2.49%(26),respectively.The drug resistance rate of CRF5501 B,CRF01AE,CRF07BC and B were 9.43%,3.10%,3.24%and 8.77%(P=0.002),respectively.The prevalence of primary drug-resistance from 2011 to 2013 were 2.44%,4.02%,and 5.40%(P=0.256),respectively.The prevalence of primary drug-resistance of three age groups(≤24,25-34,≥35)were 2.41%,4.90%and 6.12%(P=0.066),respectively.Conclusion From 2011 to 2013,the drug resistance is at a low level in antiretroviral-naive HIV-1 new reported infection among men who have sex with men in Shenzhen.There is no significant difference in primary drug resistance between different age groups.The primary drug resistance rate of CRF5501 B is significantly higher than that of other subtypes.Drug resistance of CRF5501 B should be closely monitored and analyzed in the future.

关 键 词：男男性行为者 原发性耐药 艾滋病病毒 CRF5501B 

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