江苏省2017年新报告HIV感染者治疗前耐药分析及基因亚型分布  

Drug Resistance and Diversity of Gene Distribution in HIV⁃1 Newly Diagnosed ART⁃Naïve Infections in Jiangsu,China 2017

作　　者：周莹[1] 殷玥琪 胡海洋[1] 卢静[1] 张之[1] 徐晓琴[1] 傅更锋[1] ZHOU Ying;YIN Yueqi;HU Haiyang;LU Jing;ZHANG Zhi;XU Xiaoqin;FU Gengfeng(Department of STD&HIV Control and Prevention,Jiangsu Provincial Center for Disease Control and Prevention,Nanjing 210009;School of Public Health,Southeast University,Nanjing 210009,China)

机构地区：[1]江苏省疾病预防控制中心性病与艾滋病防制所,江苏南京210009 [2]东南大学公共卫生学院流行病与卫生统计学系,江苏南京210009

出　　处：《病毒学报》2021年第4期838-844,共7页Chinese Journal of Virology

基　　金：江苏省卫生健康委科研课题(Z2018039);题目:基于限制性抗原亲和力方法的江苏省男男性行为人群HIV新发感染研究。

摘　　要：基于大样本量的亚型及治疗前耐药分析,更准确地掌握江苏省HIV-1流行亚型,更真实地评估江苏省治疗前耐药水平并为抗病毒治疗的开展提供依据收集2017年全年全江苏省新报告感染者治疗前血样。逆转录PCR扩增HIV-1蛋白酶区(pol)基因并送测序。ChromasPro剪辑,拼接,合成序列。MEGA7做序列比对并构建进化树分析亚型。序列在线比对耐药位点。治疗前耐药分析,耐药率达16.3%。蛋白酶区(PR)主要耐药位点是L33F,占44.4%。核苷酸逆转录酶区(NRTI)主要耐药位点是M184位点变异,占35%。非核苷酸逆转录酶区(NNRTI)耐药位点主要是V179位点变异,占59.2%。CRF01_AE亚型(456,37.7%)和CRF07_BC亚型(381,31.6%)仍为江苏省主要流行亚型;不同的是复杂重组体(CPXs)和独特重组体(URFs)数量极速上升至第三位(241,19.9%)。江苏省HIV-1复杂重组体大量出现,提示新入病毒或病毒交叉重组频繁,艾滋病的防制依然任重道远。在治疗前耐药比例大幅上升的情况下,治疗前耐药检测成为个体选择抗病毒治疗方案的关键。Analyze the gene distribution and drug resistance on a large number of newly diagnosed ART⁃Naïve HIV infection to better reveal HIV⁃1 subtype epidemic and evaluate drug resistance rate before anti⁃retroviral therapy(ART).We collected blood samples from ART⁃naïvein HIV⁃1 infections in Jiangsu Province,China,2017.HIV⁃1 pol regions were amplified with RT⁃PCR and sequenced.The sequences were edited with ChromasPro.Following sequences blasting,phylogenic tree was constructed with MEGA7.Drug resistance mutations were blasted online.Prevalence of drug resistance before ART is 16.3%.The mutation in PR region is L33F(44.4%).The mutation in NRTI region is M184(35%),with V179(29.2%)in NNRTI.Subtype CRF01_AE(456,37.7%)and CRF07_BC(381,31.6%)still dominated in Jiangsu,China.However,the main difference was that CPXs and URFs increased rapidly to become the third most prevalent strain.Emergence of a large number of HIV⁃1 CPXs reveals new invading virus and active recombination between viruses.It is still a severe problem in HIV prevention and control.Rising prevalence of drug resistance before ART makes personal HIV⁃1 genotype drug resistance test becoming necessary.

关 键 词：江苏省 HIV-1 治疗前耐药 亚型分布 

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