基于干血斑的北京地区未治疗的男男性行为者HIV-1传播耐药性分析  

Prevalence of HIV-1 transmitted drug resistance among MSM in Beijing based on dried blood spots

作　　者：陈凯 王月华[1] 赫晓霞[1] 姚均[1] 夏冬艳[2] 卢红艳[2] 蒋岩[1] CHEN Kai;WANG Yuehua;HE Xiaoxia;YAO Jun;XIA Dongyan;LU Hongyan;JIANG Yan(National Center for AIDS/STD Control and Prevention,China CDC,Beijing 102206,China;Beijing Center for Disease Control and Prevention,Beijing 100013)

机构地区：[1]中国疾病预防控制中心性病艾滋病预防控制中心,北京102206 [2]北京市疾病预防控制中心,北京100013

出　　处：《中国艾滋病性病》2020年第9期918-920,共3页Chinese Journal of Aids & STD

基　　金：国家“十三五”科技重大专项(2018ZX10732101-001-010);广东省科技计划项目(2016B020238002)。

摘　　要：目的为了掌握男男性行为者(MSM)中1型艾滋病病毒(HIV-1)传播耐药性(TDR)的发生率,本研究以干血斑(DBS)样本为材料,探究了北京地区未进行抗病毒治疗(ART)的MSM中传播耐药性情况。方法2017年7月至2018年4月期间,招募HIV-1阳性且未开始ART的MSM,采集其DBS样本。对HIV-1pol基因蛋白酶区和反转录酶区进行扩增并测序。通过斯坦福大学耐药突变数据库确定样本的耐药情况,并根据世界卫生组织提供的突变列表确定筛选出传播耐药突变。结果共收集到141份符合要求的DBS样本,对其中的137份成功进行扩增测序。结果表明,MSM中的传播耐药性突变的发生率为6.6%(9/137)。其中,非核苷类反转录酶抑制剂(NNRTI)相关耐药突变占比最多(3.6%),其次为核苷类反转录酶抑制剂(NRTI,2.9%)和蛋白酶抑制剂(PI,2.2%)。出现频率最高的NNRTI耐药突变为K103N(3/5),NRTI耐药突变为M184I(4/4),PI耐药突变为M46I(2/3)。结论北京地区MSM中TDR的发生率相对较高,ART开始前对该人群进行耐药检测具有重要意义。Objective To determine the prevalence of TDR among treatment-naive MSM in Beijing.Methods Dried blood spots(DBS)were collected from treatment naive HIV-1 positive MSM in Beijing from July 2017 to April 2018.The partial fragment of HIV-1 pol gene comprised of protease and reverse transcriptase regions was amplified and sequenced.Drug resistance mutations were analyzed by using the Stanford University HIV drug resistance database and TDR was defined according to the drug resistance mutation list for HIV TDR surveillance proposed by WHO.Results A total of 141 HIV-1 positive DBS samples were collected and 137 of them were sequenced successfully.The prevalence of TDR in this study was 6.6%(9/137).Among the TDRs,NNRTI associated were the most common(3.6%),while NRTI and PI were 2.9%and 2.2%,respectively.The most common NNRTI mutation was K103 N(3/5),mutations related to NRTI were M184 I(4/4)and those to PI were M46 I(2/3).Conclusion The prevalence of TDR among MSM in Beijing is relatively high,indicating that drug resistance testing before ART is of great importance among this group.

关 键 词：抗病毒治疗 干血斑 亚型 传播耐药性 

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