深圳市龙岗区男男性接触者HIV感染者流行病学特征及原发性耐药分析  

Analysis on the epidemiological characteristics and transmitted drug resistance of MSM HIV infected individuals in Longgang District,Shenzhen City

作　　者：王小丽[1] 周健明[1] 金玉娟[1] 龙清平[1] 李静媚[1] WANG Xiao-li;ZHOU Jian-ming;JIN Yu-juan;LONG Qing-ping;LI Jing-mei(Department of Emergency,Longgang Center for Disease Control and Prevention of Shenzhen,Shenzhen 518172,China)

机构地区：[1]深圳市龙岗区疾病预防控制中心应急办,深圳518172

出　　处：《中华疾病控制杂志》2021年第12期1441-1446,共6页Chinese Journal of Disease Control & Prevention

基　　金：深圳市龙岗区科技创新专项资金(LGKCYLWS2020122)。

摘　　要：目的了解深圳市龙岗区男男性接触者(men who have sex with men,MSM)、HIV感染者的流行病学特征及耐药株流行情况,为制定本区MSM、HIV感染者防控策略提供参考依据。方法收集2016―2018年本辖区新报告的MSM HIV感染者的外周静脉血血浆,提取病毒RNA,对HIV-1 pol区基因片段进行扩增并测序,采用MEGA 6.0软件构建系统进化树确定基因亚型,并以斯坦福大学HIV耐药数据库进行耐药分析。结果从148例病例样本中成功扩增119份,其亚型分布包括CRF07_(B)C(45.38%,54/119)、CRF01_(A)E (28.57%,34/119)、CRF55_(0)1B (25.21%,30/119)和B亚型(0.84%,1/119)。2016―2018年深圳市龙岗区MSM HIV/AIDS患者抗病毒治疗前HIV-1耐药株流行率为4.20%(5/119),对核苷类反转录酶抑制剂(nucleoside reverse transcriptase inhibitors,NRTIs)耐药率最高为2.52%(3/119)。总体耐药突变率为31.1%(37/119),CRF55_(0)1B亚型感染者均出现耐非核苷类反转录酶抑制剂(non-nucleoside reverse transcriptase inhibitors,NNRTIs)的V179E突变。结论 2016―2018年龙岗区新增确证的MSM HIV感染者处于低耐药水平。需进一步关注V179D/E突变对临床一线药物治疗CRF55_(0)1B亚型感染者疗效的影响。Objective To understand the epidemiological characteristics of HIV infected individuals and the prevalence of drug-resistant strains among men who have sex with men(MSM) in Longgang District of Shenzhen City,so as to provide guidance for the development of MSM HIV infected individuals prevention and control policy.Methods Perioheral venous blood plasma of newly reported MSM HIV infected individuals were collected in Longgang District of Shenzhen City from 2016 to 2018.After extracting viral RNA,the HIV-1 pol region gene fragments were amplified and sequenced.The phylogenetic tree was constructed by the MEGA 6.0 software for HIV genotype determination.Drug resistance was analyzed by using the Stanford University’s HIV drug resistance database.Results A total of 119 among 148 samples were successfully amplified,including subtypes of CRF07_(B)C(45.38%,54/119),CRF01_(A)E(28.57%,34/119),CRF55_(0)1 B(25.21%,30/119) and B subtype(0.84%,1/119).The prevalence rate of HIV-1 drug-resistant strains in MSM HIV infected individuals in Longgang District before antiviral treatment was 4.20%(5/119),and the drug-resistant rate to nucleoside reverse transcriptase inhibitors(NRTIs) was the highest 2.52%(3/119) during 2016 to 2018.The overall drug resistance mutation rate was 31.1%(37/119).All patients infected with CRF55_(0)1 B subtype had V179 E mutation resistant to non-nucleoside reverse transcriptase inhibitors(NNRTIs).Conclusion The newly confirmed MSM HIV infected individuals in Longgang District from 2016 to 2018 is at a low drug resistance level.Further attention should be paid to the effect of V179 D/E mutation on the efficacy of clinical first-line drugs in the treatment of patients with CRF55_(0)1 B subtype infection.

关 键 词：流行病学特征 MSM 耐药分析 

分 类 号：R512.91[医药卫生—内科学]