2019-2020年昆明市MSM HIV-1感染者中整合酶抑制剂耐药及分子网络特征  

Characteristics of HIV-1 integrase inhibitor resistance and molecular networks among men who have sex with men in Kunming city, 2019-2020

作　　者：孙鹏艳 陈会超[1] 戴洁[1] 董莉娟[1] 金晓媚[1] 杨敏 曾志君 马艳玲[1] 陈敏[1] SUN Pengyan;CHEN Huichao;DAI Jie;DONG Lijuan;JIN Xiaomei;YANG Min;ZENG Zhijun;MA Yanling;CHEN Min(Institute for AIDS/STDs Prevention and Control,Yunnan Provincial Center for Disease Control and Prevention,Yunnan,Kunming 650022,China)

机构地区：[1]云南省疾病预防控制中心性病艾滋病防制所,昆明650022

出　　处：《中国艾滋病性病》2023年第4期448-452,共5页Chinese Journal of Aids & STD

基　　金：云南省科技人才和平台计划项目(2019HB053);“十三五”国家科技重大专项(2018ZX10715006)。

摘　　要：目的 了解昆明市MSM HIV-1感染者中整合酶抑制剂(INSTIs)耐药流行情况及分子网络特征。方法收集2019-2020年昆明市新报告HIV-1抗体阳性的MSM血浆样本202份,提取病毒RNA,通过反转录和巢式聚合酶链式反应对编码整合酶的基因片段进行扩增和测序,并分析序列的基因型、基因距离、整合酶抑制剂的耐药突变位点,构建分子网络。结果 在获得的163份样品的整合酶区基因片段中,主要的基因型为C亚型(50.9%,83/163)和CRF01_AE(27.6%,45/163),其他包括URF(12.9%,21/163),CRF55_01B(5.5%,9/163)和B亚型(3.1%,5/163)。其中B亚型的基因距离最大,其次为CRF01_AE,而C亚型和CRF55_01B小于前两者。在研究对象中检出1例样品携带INSTIs的辅助耐药突变位点G163K,耐药位点检出率为0.6%(1/163)。共有60条序列进入网络,≤20岁年龄组的感染者更容易成簇。结论 昆明MSM中INSTIs的耐药率仍处于较低的流行水平。低年龄组的MSM更活跃,在干预措施的覆盖和有效实施上还有待进一步提高。Objective To investigate the prevalence of drug resistance to integrase strand transfer inhibitors(INSTIs)related resistance mutations and the characteristic of the HIV-1 molecular network among MSM living with HIV in Kunming. Methods A total of 202 newly reported anti-HIV-1 antibody-positive blood samples were collected from MSM from 2019 to 2020 in Kunming City. HIV-1 RNA was extracted and the gene fragment of the integrase region was amplified through the reverse transcript and nest-PCR. All integrase fragments gained were used to analyze HIV-1subtypes, genetic distance, and integrase inhibitor-related resistance mutations, and then HIV-1 molecular networks were constructed. Results Among the 163 sequences obtained, the predominant HIV-1 strains were subtype C(50.9%, 83/163)and CRF01_AE(27.6%, 45/163). The others included URF(12.9%, 21/163), CRF55_01B(5.5%, 9/163) and subtype B(3.1%, 5/163). The genetic distance within subtype B was the largest, followed by that within CRF01_AE, while those within subtype C and CRF55_01B were smaller than the first two. One accessory mutation G163K was detected and the overall rate of integrase inhibitor resistance mutation was 0.6%(1/163). 60 sequences in total were entered into the networks, and ages≤20 are more likely to get involved in networks. Conclusions The prevalence of INSTIs resistance among MSM in Kunming remained at a low level. The younger age group is more active and effective interventions need to be implemented.

关 键 词：艾滋病病毒 男男性行为者 整合酶抑制剂 耐药 分子网络 

分 类 号：R373.9[医药卫生—病原生物学]