深圳市龙岗区新确证HIV/AIDS病例的亚型分布及耐药分析  

Genotype distribution and transmitted drug resistance analysis of newly-diagnosed HIV/AIDS patients in Longgang district of Shenzhen

作　　者：周健明[1] 李静媚[1] 龙清平[1] 王小丽[1] 王琼瑶[1] 林泽仁 金玉娟[1] ZHOU Jian-ming;LI Jing-mei;LONG Qing-ping;WANG Xiao-li;WANG Qiong-yao;LIN Ze-ren;JIN Yu-juan(Longgang District Center for Disease Control and Prevention,Shenzhen,Guangdong 518172,China)

机构地区：[1]深圳市龙岗区疾病预防控制中心,广东深圳518172

出　　处：《中国热带医学》2022年第1期68-73,共6页China Tropical Medicine

基　　金：深圳市龙岗区医疗卫生科技计划项目(No.LGKCYLWS2020122)。

摘　　要：目的了解深圳市龙岗区新增确证艾滋病病毒感染者(HIV)/艾滋病病人(AIDS)的流行病学特征、HIV-1亚型分布及耐药株流行状况,为当地的艾滋病防控提供参考依据。方法对深圳市龙岗区2016—2019年新报告HIV/AIDS病例开展流行病学横断面研究,按年分层随机抽取432例HIV/AIDS患者血清并提取病毒RNA,一步法逆转录PCR和巢式PCR法扩增HIV-1 pol区基因并测序,以邻接法(Neighbor-Joining method,NJ)构建系统进化树鉴定亚型,通过美国斯坦福大学HIV耐药数据库进行耐药分析。结果研究对象1519例中男性占比最高(88.61%,1346/1519),广东省以外户籍居多(66.16%,1005/1519),同性传播比例多于异性传播,54.58%(829/1519)新增病例的CD4^(+)T淋巴细胞≥350个/µL。成功获得368份pol基因序列,共发现11种HIV-1基因亚型及17例独特重组型(URF),优势亚型为CRF01_AE和CRF07_BC,其他包括CRF55_01B、B亚型、CRF08_BC、CRF 59_01B,C亚型、G亚型、CRF 67_01B、CRF79_0107和CRF 68_01B。共发现33个传播簇(含79例),总成簇比例为21.47%(79/368),其中CRF55_01B成簇比最高,为44.90%(22/49),高于主要亚型的CRF01_AE及CRF07_BC。14例感染者具有WHO推荐的耐药突变位点,传播性耐药(transmitted drug resistance,TDR)耐药率为3.80%,TDR突变以非核苷酸反转录酶抑制剂(NNRTIs)为主,CRF01_AE亚型的耐药突变率最高。结论深圳市龙岗区新确证HIV/AIDS病例中,HIV-1亚型分布复杂多样,总体耐药率处于低水平,重组亚型CRF55_01B的感染者已成簇传播,应加强对该人群开展靶向干预。Objective This study aim to realize the epidemiological characteristics,genotype distribution of HIV-1 and epidemic situation of drug resistance in newly-reported HIV infections in Longgang district of Shenzhen.It provides a reference for the overall prevention and control of AIDS in the local area.Methods A cross-sectional study of epidemiology was proceeded on newly-identified HIV/AIDS infections in Longgang district,Shenzhen during 2016-2019.432 plasma samples were collected by random sampling,and its RNA were extracted.The pol fragment of HIV-1 genome was amplified by one-step RT-PCR and nested-PCR and was sequenced.Subtype analysis was performed by phylogenetic tree with neighbor-joining method.The HIV resistance mutations were determined with the use of Stanford University HIV Drug Resistance Database.Results Subjects were majority males(88.61%,1346/1519)and migrants(66.16%,1005/1519),and the proportion of HIV infections through Homosexual behavior were higher in infected mainly through heterosexual behavior.The CD4^(+)T lymphocyte counts of HIV patients were 54.58%(829/1519)above 350 cells/µL.368 segments were successfully amplified,among which 11 genotypes of HIV-1 and 17 URF strains were found.The main subtypes were CRF01_AE and CRF07_BC,others were CRF55_01B,B,CRF08_BC,CRF 59_01B,C,G,CRF 67_01B,CRF79_0107 and CRF 68_01B.33 transmission clusters were found,with the total clustered rate of 21.47%(79/368).CRF55_01B had the highest cluster rate(44.90%,22/49),which was higher than the major subtypes CRF01_AE and CRF07_BC.The drug resistance mutations of WHO recommendation were found in fourteen samples.The overall rate of transmitted drug resistance(TDR)was 3.80%.TDR was predominantly towards NNRTIs,and the subtype CRF01_AE showed the highest drug resistance mutation rate.Conclusions The distribution of HIV-1 subtypes of newly reported HIV/AIDS in Longgang district of Shenzhen is complex and diverse,and the overall drug resistance rate remain at a low level.The clustering transmission of HIV-infection of CR

关 键 词：艾滋病病毒 亚型 传播性耐药 

分 类 号：R561[医药卫生—呼吸系统]