天津市青年男男同性性行为人类免疫缺陷病毒感染者治疗前毒株耐药情况分析  

Pretrement drug resistance among HIV-infected young men who have sex with men in Tianjin

作　　者：李龙[1] 郑敏娜[1] 郭燕[1] 宁铁林[1] 龚卉[1] 赵芳凝 于茂河[1] LI Long;ZHENG Min-na;GUO Yan;NING Tie-lin;GONG Hui;ZHAO Fang-ning;YU Mao-he(Department for AIDS/STD Control and Prevention,Tianjin Center for Disease Control and Prevention,Tianjin Key Laboratory of Pathogenic Microbiology of Infectious Disease,Tianjin 3oooll,China)

机构地区：[1]天津市疾病预防控制中心性病艾滋病预防控制所天津市传染病病原微生物重点实验室,天津300011

出　　处：《中国病毒病杂志》2022年第6期448-452,共5页Chinese Journal of Viral Diseases

基　　金：天津市卫生健康科技项目(ZC20022,TJWJ2022QN094)。

摘　　要：目的 了解天津市青年男男同性性行为人类免疫缺陷病毒(human immunodeficiency virus,HIV)感染者治疗前耐药(pretrement drug resistance,PDR)特征,为临床治疗提供科学依据。方法 选取2015年1月—2018年12月天津市新诊断的120例青年男男同性性行为HIV感染者为研究对象,收集其人口学信息和治疗前的血浆样本,提取样本核酸后用巢式PCR法扩增HIV-1的pol基因。测序后成功获得105例pol基因序列样本,用于基因分型和治疗前耐药分析。结果 105份样本中,CRF01_AE和CRF07_BC亚型毒株占比最高,分别占53.33%(56/105)和27.62%(29/105),B亚型占6.67%(7/105),CRF55_01B占3.81%(4/105),CRF68_01B占0.95%(1/105),另外独特重组型(unique recombinant form,URF)占7.62%(8/105)。有4例重组模式相同,在pol基因2568~2592处发生了CRF01_AE/C片段重组。共发现11例耐药,治疗前耐药率10.48%(11/105)。发现7种药物耐药,其中奈韦拉平(NVP)和依非韦仑(EFV)耐药率分别为8.57%(9/105)和6.67%(7/105)。结论 CRF01_AE和CRF07_BC亚型是天津市青年男男同性性行为HIV感染者的主要流行毒株,并且出现了一定数量的重组毒株,治疗前耐药率处于中度流行水平,毒株对NVP和EFV的耐药率已较高,应当引起临床机构的重视。Objective To understand the characteristics of pre treatment drug resistance(PDR) in young men with gay sexual behavior infected with human immunodeficiency virus(HIV) in Tianjin,thus to provide scientific bases for clinical treatment.Methods One hundred and twenty newly diagnosed HIV-infected young MSMs were enrolled in Tianjin from January 2015 to December 2018.Demographic information and blood samples before treatment were collected,and the pol gene of HIV-1 was amplified by nested PCR after nucleic acid extraction.One hundred and five pol gene sequences were successfully obtained and the genotypes and drug resistance were analyzed.Results Among 105 samples,CRF01AE and CRF07BC were dominant genotypes,accounting for 53.33%(56/105) and 27.62%(29/105),followed by B,CRF5501B,CRF6801B and URF subtypes,accounting for 6.67%(7/105),3.81 %(4/105),0.95%(1/105) and7.62%(8/105),respectively.Four cases shared the same recombination pattern in which CRF01AE/C fragment recombination occurred at pol gene 2568—2592.A total of 11 cases with resistance to mainly 7 drugs were identified,with the overall pretreatment drug resistance rate of 10.48%(11/105).The resistance rates to NVP and EFV were 8.57%(9/105) and 6.67%(7/105),respectively.Conclusions CRF01AE and CRF07BC subtypes are the main epidemic strains among HIV-infected young MSMs in Tianjin,and a certain number of recombinant strains exist.The pretreatment drug resistance rate is at a medium level.The pretrement drug resistance rates of NVP and EFV are relatively high,thus clinical department should pay more attention to it.

关 键 词：人类免疫缺陷病毒 男男同性性行为 治疗前耐药 巢式PCR 

分 类 号：R512.91[医药卫生—内科学]