黑龙江省588例新报告HIV-1感染者病毒基因特征及耐药分析  

Analysis of viral genetic characteristics and drug resistance among 588 newly reported HIV-1 patients in Heilongjiang Province from 2019 to 2021

作　　者：宋潇 李婷[1] 江云飞 李一[1] 惠珊[1] 于兰[1] 佟雪[1] 肖纯 孙巍[1] SONG Xiao;LI Ting;JIANG Yunfei;LI Yi;HUI Shan;YU Lan;TONG Xue;XIAO Chun;SUN Wei(Center for Disease Prevention and Control of Heilongjiang Province,Harbin 150030,China)

机构地区：[1]黑龙江省疾病预防控制中心,哈尔滨150030

出　　处：《中国艾滋病性病》2022年第7期781-785,共5页Chinese Journal of Aids & STD

基　　金：黑龙江省卫健委科研课题(2020-193)。

摘　　要：目的分析和评估黑龙江省新报告部分HIV-1感染者病毒基因型特征及耐药水平,对疫情精准防控措施的制定以及干预效果评价提供新的依据。方法对黑龙江省2019-2021年新报告ART前HIV-1感染者进行调查分析。对获取的人群血清核酸提取、病毒pol区基因扩增以及构建进化树。应用耐药数据库和HIV-TRACE进行耐药分析和构建网络。采用多因素Logistic模型对入网人群特征进行分析。结果从研究对象中获得588条序列。HIV-1毒株以CRF01_AE亚型为主,占56.63%(333/588),该亚型中又以Cluster 5和Cluster 4为主。人群HIV-1耐药率为9.52%(56/588),针对NNRTI耐药率4.93%,NRTI耐药率0.51%和PI耐药率4.08%。以1.5%基因阈值构建的分子网络,入网率为41.33%(243/588),产生73个分子簇。网络内63.92%(101/158)异性性行为感染者与MSM感染人群有混合边。多因素分析显示,CRF01_AE亚型感染人群、年龄30岁以上、未婚者和初中文化程度感染者入网风险较大(P<0.05)。结论588例新报告感染者HIV-1毒株以CRF01_AE Cluster 5和Cluster 4为主,治疗前患者耐药率处于中等水平,MSM感染者为网络内活跃人群。应加强感染者的耐药监测和网络“桥梁人群”的干预。Objective To analyze and evaluate the viral genotype characteristics and drug resistance levels of newly reported HIV-1-infected patients in Heilongjiang Province,and to provide a new basis for the development of precise prevention and control measures for the epidemic as well as the evaluation of intervention effects.Methods A survey and analysis of newly reported HIV-1 infected patients before antiretroviral treatment in Heilongjiang province from 2019to 2021.Nucleic acid extraction from the obtained population serum,gene amplification of the pol region of the virus,and construction of an evolutionary tree.The drug resistance database and HIV-TRACE were applied for drug resistance analysis and network construction.And the differential analysis of the enrolled population was performed.Results The HIV-1 strains were predominantly CRF01_AE subtypes,accounting for 56.63%(333/588) of the study population,with male homologous clusters Cluster5 and Cluster4 predominating.The HIV-1 resistance rate in the population was 9.52%(56/588),4.93% against NNRTI,0.51% against NRTI and 4.08% against PI.The molecular network constructed with a1.5% gene threshold had an entry rate of 41.33%,yielding 73 molecular clusters.Within the network 63.92% of heterosexual infected individuals had mixed edges with the MSM population.In contrast,CRF01_AE subtype infected population,those aged 30 years or older,unmarried and with a middle school education level were at greater risk of network entry(P<0.05).Conclusions The HIV-1 strains of 588 newly reported infected persons in Heilongjiang Province were dominated by CRF01_AE Cluster5 and Cluster4,and the drug resistance rate of pre-treatment patients is at a moderate level,and MSM are the active population in the network.The drug resistance monitoring of infected patients and the intervention of the network "bridge population" should be strengthened.

关 键 词：1型艾滋病病毒 基因亚型 分子网络 基因型耐药 

分 类 号：R373.9[医药卫生—病原生物学]