2019—2020年北京市未治疗HIV-1感染者传播性耐药特征分析  

Characteristics of transmitted drug resistance in treatment-naive HIV-1-infected individuals in Beijing city,2019-2020

作　　者：辛若雷[1] 黄辉煌 李佳[1] 郝尹虓[1] 孙伟东[1] 李洁[1] 卢红艳[1] 黄春[1] Xin Ruolei;Huang Huihuang;Li Jia;Hao Yinxiao;Sun Weidong;Li Jie;Lu Hongyan;Huang Chun(STD/AIDS Prevention and Treatment Center,Beijing Center for Disease Prevention and Control,Beijing Research Center for Preventive Medicine,Beijing 100013,China;Center for Infectious Disease Diagnosis and Therapy,Fifth Medical Center of the People’s Liberation Army(PLA)General Hospital,Beijing 100039,China)

机构地区：[1]北京市疾病预防控制中心北京市预防医学研究中心性病艾滋病防治所,100013 [2]解放军总医院第五医学中心感染性疾病诊疗与研究中心,北京100039

出　　处：《中华实验和临床病毒学杂志》2021年第4期367-371,共5页Chinese Journal of Experimental and Clinical Virology

基　　金：北京市自然科学基金(7202074);北京市科技计划项目(D161100000416002)。

摘　　要：目的:了解北京市未治疗HIV-1感染者蛋白酶-逆转录酶和整合酶基因型耐药发生水平和特征,为临床诊疗提供数据参考。方法:于2019—2020年募集北京市新确诊或新入组接受抗逆转录病毒治疗HIV-1感染者,进行pol基因片段和整合酶基因扩增和测序。系统进化分析判断病毒亚型,通过HIV耐药数据库比对解析耐药突变和药物耐受程度。结果:在募集到的168例病例中,93.6%通过男男性行为途径感染。最主要流行毒株为CRF01_AE(41.0%)和CRF07_BC(30.3%),独特重组型占16.1%。6个病例携带蛋白酶-逆转录酶监测性耐药突变,传播性耐药发生率为3.7%;1个病例治疗基线携带核苷类逆转录酶抑制剂类K65R突变,同时伴有整合酶基因区主要突变T66I(0.6%),对艾维雷韦高度耐受、对拉替拉韦低度耐受。结论:北京市未治疗HIV-1感染者中HIV-1传播性耐药发生率低,应加强包括整合酶基因在内的基因型耐药监测。Objective To explore the characteristics of HIV-1 genotypic drug resistance for protease-reverse transcriptase(PR-RT)and integrase(IN)among antiretroviral therapy(ART)-naive individuals in Beijing,and provide evidence for clinical diagnosis and treatment.Methods Newly diagnosed individuals or cases initiating ART were recruited in Beijing covering 2019 to 2020,then pol gene fragments and integrase gene were synchronously amplified and sequenced.Phylogenetic analyses were performed to determine subtypes,and the pol gene and integrase gene sequences were submitted to Stanford University HIV drug resistance database for the interpretation of mutations and drug resistance.Results Among 168 ART-naive individuals,93.6%were infected via men who have sex with men(MSM).The top two subtypes were CRF01_AE(41.0%)and CRF07_BC(30.3%),and unique recombinant forms accounted for 16.1%infections.Six individuals carried surveillance drug resistance mutations in PR-RT,with a prevalence of transmitted drug resistance(TDR)at 3.7%.And one case carried nucleoside reverse transcriptase inhibitor mutation of K65R,accompanied with major integrase mutation of T66I(0.6%),conveying resistance to elvitegravir and raltegravir at high and low levels,respectively.Conclusions The prevalence of transmitted drug resistance was considerably low among ART-naive individuals in Beijing,and the surveillance of genotypic drug resistance should be strengthened,including integrase drug resistance.

关 键 词：人免疫缺陷病毒 基因型耐药 传播性耐药 整合酶抑制剂 

分 类 号：R51[医药卫生—内科学]