2016—2019年深圳市龙岗区16~25岁HIV感染者病毒亚型及耐药特征分析  

Analysis of subtypes and drug resistance in HIV infected patients aged 16 to 25 years in Longgang District,Shenzhen,2016—2019

作　　者：许华文 周健明[2] 金玉娟[2] 李静媚[2] 龙清平[2] 刘渠[2] 王德全 XU Hua-wen;ZHOU Jian-ming;JIN Yu-juan;LI Jing-mei;LONG Qing-ping;LIU Qu;WANG De-quan(School of Public Health,Guangdong Pharmaceutical University,Guangzhou,Guangdong 510310,China)

机构地区：[1]广东药科大学公共卫生学院,广东广州510310 [2]深圳市龙岗区疾病预防控制中心,广东深圳518172

出　　处：《现代预防医学》2022年第18期3415-3420,共6页Modern Preventive Medicine

基　　金：深圳市龙岗区医疗卫生科技计划项目(LGKCYLWS2020122)。

摘　　要：目的了解深圳市龙岗区抗病毒治疗前HIV-1感染者基因亚型和耐药株流行现况。方法HIV/AIDS流行病学数据来源于全国艾滋病综合防治数据信息管理系统。采用描述性研究方法,对HIV感染者的流行特征进行统计分析,率和构成比的比较采用χ^(2)检验或Fisher精确检验。收集2016—2019年新报告的16~25岁的HIV感染者血清样品,扩增HIV pol区全部蛋白酶基因和部分逆转录酶基因区域,测序后进行HIV-1基因分型和耐药突变位点分析。结果173份血清样品成功获得pol序列片段,男性占93.64%(162/173),单身占95.95%(166/173),外省户籍者占65.32%(112/173),同性性传播占67.63%(117/173)。HIV-1亚型以CRF07_BC(43.35%)和CRF01_AE(32.95%)为主,其次为CRF55_01B(13.87%)、B(5.78%)和其他亚型(4.05%)。不同年份HIV-1亚型分布差异有统计学意义(H=9.456,P=0.042)。总传播耐药率为5.78%(10/173),非核苷类反转录酶抑制剂(NNRTIs)耐药率为4.62%(8/173),核苷类反转录酶抑制剂(NRTIs)为2.31%(4/173)。同性性传播的耐药率为7.69%(9/117),异性性传播为1.79%(1/56)。突变发生率为21.97%(38/173),未检测出PIs突变,主要耐药突变位点中5个针对NNRTIs和4个针对NRTIs。次要突变V179D/E高达17.34%(30/173),主要发生在CRF55_01B亚型,不同HIV-1亚型检测出V179D/E突变差异有统计学意义(χ^(2)=91.733,P<0.001)。5例病例对一线治疗药物NNRTIs耐药,1例对NNRTIs和NRTIs双重耐药。结论2016—2019年深圳市龙岗区HIV-1亚型分布表现为以CRF07_BC和CRF01_AE为主,多个亚型共存的特点。HIV-1感染者原发耐药率已达到中度水平,MSM人群中NNRTIs类药物的耐药需引起重视。应加强年轻的MSM人群的耐药监测。Objective To understand the prevalence of HIV-1 genotypes and the transmitted drug resistance in HIV-1 infected patients before antiviral treatment in Longgang District,Shenzhen.Methods The epidemiological data were obtained from the National HIV/AIDS Comprehensive Response Information Management System.Descriptive research method was used to conduct statistical analysis on the epidemic characteristics of HIV infected persons.Chi-square test or Fisher’s exact test was used for comparison of rates and constituent ratios.Newly reported HIV-positive serum samples from 16 to 25 years old were collected from 2016 to 2019.Partial gene of HIV pol was amplified and sequenced.The pol sequences were used to analyze HIV-1 subtypes and drug resistance.Results A total of 173 samples were successfully sequenced.Among them,males accounted for 93.63%(162/173),the unmarried accounted for 95.95%(166/173),the residents registered in other provinces accounted for 65.32%(112/173),and homosexual transmission accounted for 67.63%(117/173).The distribution of subtypes was predominated by CRF07_BC(43.35%),followed by CRF01_AE(32.95%),CRF55_01B(13.87%),B(5.78%)and other subtypes(4.05%).The distributions of HIV-1 subtypes in different years were significantly different(H=9.456,P=0.042).The overall prevalence of transmitted drug resistance was 5.78%(10/173),the prevalence of transmitted drug resistance to non-nucleoside reverse transcriptase inhibitors(NNTIs)and nucleoside reverse transcriptase inhibitors(NRTIs)were 4.62%(8/173)and 2.31%(4/173),respectively.The prevalence of transmitted drug resistance in homosexual transmission and heterosexual transmission were 7.69%(9/117)and 1.79%(1/56),respectively.The mutation rate was 21.97%(38/173).No drug resistance mutation was detected in protease inhibitors(PIs).The major NNRTIs and NRTIs resistance mutations were 5 and 4,respectively.The accessory mutation V179D/E was up to 17.34%(30/173),mainly occurring in CRF55_01B subtype.The distribution of V179D/E mutation among different HIV-1 subtypes

关 键 词：艾滋病病毒 基因亚型 耐药 

分 类 号：R512.91[医药卫生—内科学]