广西南宁市注射吸毒人群HIV-1感染者基因亚型及耐药分析  

Prevalence of genotype subtypes and antiretroviral drug resistance in injecting drug users infected with HIV-1 in Nanning city,Guangxi Province

作　　者：岑平[1] 梁冰玉[2] 汤洪洋[1] 莫巨聪[1] 邓小芳[1] 梁浩[2] 阳世雄 梁华悦 CEN Ping;LIANG Bing-yu;TANG Hong-yang;MO Ju-cong;DENG Xiao-fang;LIANG Hao;YANG Shi-xiong;LIANG Hua-yue(Nanning Center for Disease Control and Prevention,Guangxi 530023,China;不详)

机构地区：[1]南宁市疾病预防控制中心,广西530023 [2]广西医科大学

出　　处：《现代预防医学》2021年第19期3605-3610,共6页Modern Preventive Medicine

基　　金：广西自然科学基金青年基金项目(2018GXNSFBA281047);南宁市科技局重点研发项目(20183039-1);南宁市学术和技术带头人培养项目专项资金资助项目(2017015)。

摘　　要：目的分析广西南宁市注射吸毒人群中HIV-1分子基因亚型及耐药的特征。方法2017—2019年在南宁市连续收集感染HIV-1的注射吸毒人群样本225份,通过巢式PCR扩增HIV-1 pol区基因,基于最适基因距离构建分子传播网络,并分析入网率、耐药情况及其相关影响因素。结果163份样本获得HIV-1 pol区序列,检测到4种HIV-1基因型,其中以CRF08BC(55.2%,90/163)和CRF01AE(35.6%,58/163)为主。共有83条序列入网,入网率50.9%(83/163),形成19个分子传播簇,其中有1个传播簇包含19个节点。163条序列进行耐药分析,共出现24例HIV-1耐药株,NRTIs、NNRTIs和PIs的耐药率分别为2.5%(4/163,95%CI:0.1%~4.9%)、10.4%(17/163,95%CI:5.7%~15.2%)和2.5%(4/163,95%CI:0.1%~4.9%)。83条未治疗序列中获得4条治疗前耐药株,其中1例出现PIs低度耐药,2例出现NNRTIs高度耐药,1例同时产生NRTIs和NNRTIs耐药突变。结论南宁市IDU HIV-1感染者中病毒基因亚型呈现多样性,其中以CRF08BC占优势,并出现超级传播者。抗病毒治疗耐药情况较为严峻,以NNRTIs耐药为主,原发性耐药处于较低水平,一线抗病毒疗法仍有效,但要密切关注耐药监测,防止多重和交叉耐药毒株的流行。Objective To analyze the characteristics of HIV-1 gene subtypes and drug resistance among injecting drug users(IDUs)in Nanning,Guangxi.Methods 225 samples of HIV-1 infected IDUs were collected in Nanning city from 2017 to 2019.The pol gene of HIV-1 was amplified by nested PCR.The molecular transmission network was constructed based on the optimal gene distance.The network access rate,drug resistance and related factors were analyzed.Results HIV-1 pol gene segments were obtained from the serums of 163 HIV-1 infected IDUs.The distribution of subtypes was predominated by CRF08BC(55.2%,90/163)and CRF01AE(35.6%,58/163).A total of 83 sequences were involved in the network,and the network access rate was 50.9%(83/163),forming 19 molecular propagation clusters,one of which contained 19 nodes.163 sequences were analyzed for drug resistance,and 24 HIV-1 drug-resistant strains were found.The resistance rates of NRTIs,NNRTIs and PIs were 2.5%(4/163,95%CI:0.1%-4.9%),10.4%(17/163,95%CI:5.7%-15.2%)and 2.5%(4/163,95%CI:0.1%-4.9%),respectively.Among the 83 untreated sequences,4 primary drug-resistant strains were obtained,including 1 case of low PIs resistance,2 cases of high NNRTIs resistance,and 1 case of NRTIs and NNRTIs resistance mutation.Conclusion The genotypes of HIV-1 infected IDUs in Nanning show diversity.CRF08BC is dominant and super communicators appear.The drug resistance of antiviral therapy is severe,mainly NNRTIs,and the primary drug resistance is at a low level.The first-line antiviral therapy is still effective,but we should pay close attention to drug resistance monitoring in order to prevent the prevalence of multi and cross-resistant strains.

关 键 词：HIV-1 注射吸毒人群 基因亚型 耐药 

分 类 号：R512.91[医药卫生—内科学]