广西≥50岁男性新报告人类免疫缺陷病毒感染者的基因亚型及治疗前耐药分析  

Genetic Subtypes and Pretreatment Drug Resistance in the Newly Reported Human Immunodeficiency Virus-Infected Men Aged≥50 Years Old in Guangxi

作　　者：方宁烨[1] 韦文翠 李剑军[1] 岑平[3] 冯献湘 阳冬 唐凯玲 梁淑家[1] 邵玉兰[2] 陆华湘[1] 江河[1] 孟琴[1] 刘帅凤[1] 朱秋映[1] 陈欢欢[1] 蓝光华[1] 阳世雄 周丽芳 莫靖林[5] 葛宪民[1] FANG Ningye;WEI Wencui;LI Jianjun;CEN Ping;FENG Xianxiang;YANG Dong;TANG Kailing;LIANG Shujia;SHAO Yulan;LU Huaxiang;JIANG He;MENG Qin;LIU Shuaifeng;ZHU Qiuying;CHEN Huanhuan;LAN Guanghua;YANG Shixiong;ZHOU Lifang;MO Jinglin;GE Xianmin(Institute of HIV/AIDS Prevention and Control,Guangxi Zhuang Autonomous Region Center for Disease Prevention and Control,Nanning 530028,China;Department of Clinical Examination,Guigang Center for Disease Control and Prevention,Guigang,Guangxi 537100,China;Department of HIV/AIDS/STD Prevention and Control,Nanning Center for Disease Control and Prevention,Nanning 530023,China;Institute of HIV/AIDS Prevention and Control,Liuzhou Center for Disease Control and Prevention,Liuzhou,Guangxi 545007,China;Department of HIV/AIDS/STD Prevention and Control,Guilin Center for Disease Control and Prevention,Guilin,Guangxi 541001,China)

机构地区：[1]广西壮族自治区疾病预防控制中心艾滋病防制所,南宁530028 [2]贵港市疾病预防控制中心检验科,广西贵港537100 [3]南宁市疾病预防控制中心性病艾滋病防制科,南宁530023 [4]柳州市疾病预防控制中心艾滋病防制所,广西柳州545007 [5]桂林市疾病预防控制中心性病艾滋病防制科,广西桂林541001

出　　处：《中国医学科学院学报》2023年第3期399-404,共6页Acta Academiae Medicinae Sinicae

基　　金：广西重点研发计划(AB19245044);广西自然科学基金(2020GXNSFAA159020);广西艾滋病防控与成果转化研究重点实验(ZZH2020010);广西八桂学者艾滋病防控关键技术岗位专项(桂办公厅发[2019]79号);广西医疗卫生重点学科建设项目。

摘　　要：目的 分析广西≥50岁男性新报告人类免疫缺陷病毒(HIV)感染者的基因亚型及治疗前耐药情况。方法 采用分层随机抽样法,选取广西14个城市2020年1至6月新报告≥50岁男性HIV感染者,采用巢式逆转录聚合酶链反应扩增HIV-1 pol基因片段进行测序,分析耐药突变位点及耐药程度。结果 共615例HIV感染者纳入分析,CRF01_AE、CRF07_BC和CRF08_BC 3种主要亚型的构成比分别为57.4%(353/615)、17.1%(105/615)和22.4%(138/615)。核苷逆转录酶抑制剂(NRTI)、非NRTI(NNRTI)和蛋白酶抑制剂发生耐药位点突变例数分别为8例(1.3%)、18例(2.9%)和0例。NRTI和NNRTI位点突变率最高的分别为M184V(0.7%)和K103N(1.8%)。22例(3.6%)至少对任意一类逆转录酶抑制剂产生耐药,其中,对NRTI耐药4例(0.7%)、NNRTI耐药14例(2.3%),同时产生耐药4例(0.7%);对蛋白酶抑制剂未产生耐药。NNRTI治疗前耐药率高于NRTI(2.9%比1.3%;χ^(2)=3.929,P=0.047)。拉米夫定、齐多夫定、替诺福韦、阿巴卡韦、利匹韦林、依非韦伦、奈韦拉平和洛匹那韦/利托那韦的治疗前耐药所占比例分别为0.8%、0.3%、0.7%、1.0%、1.3%、2.8%、2.9%和0。结论 CRF01_AE、CRF07_BC和CRF08_BC为2020年广西新报告≥50岁男性HIV感染者主要流行毒株,其治疗前耐药仍处于低度流行水平。Objective To analyze the genetic subtypes of human immunodeficiency virus(HIV)and the prevalence of pretreatment drug resistance in the newly reported HIV-infected men in Guangxi.Methods The stratified random sampling method was employed to select the newly reported HIV-infected men aged≥50 years old in 14 cities of Guangxi from January to June in 2020.The pol gene of HIV-1 was amplified by nested reverse transcription polymerase chain reaction and then sequenced.The mutation sites associated with drug resistance and the degree of drug resistance were then analyzed.Results A total of 615 HIV-infected men were included in the study.The genetic subtypes of CRF01_AE,CRF07_BC,and CRF08_BC accounted for 57.4%(353/615),17.1%(105/615),and 22.4%(138/615),respectively.The mutations associated with the resistance to nucleoside reverse transcriptase inhibitors(NRTI),non-nucleoside reverse transcriptase inhibitors(NNRTI),and protease inhibitors occurred in 8(1.3%),18(2.9%),and 0 patients,respectively.M184V(0.7%)and K103N(1.8%)were the mutations with the highest occurrence rates for the resistance to NRTIs and NNRTIs,respectively.Twenty-two(3.6%)patients were resistant to at least one type of inhibitors.Specifically,4(0.7%),14(2.3%),4(0.7%),and 0 patients were resistant to NRTIs,NNRTIs,both NRTIs and NNRTIs,and protease inhibitors,respectively.The pretreatment resistance to NNRTIs had much higher frequency than that to NRTIs(2.9%vs.1.3%;χ^(2)=3.929,P=0.047).The prevalence of pretreatment resistance to lamivudine,zidovudine,tenofovir,abacavir,rilpivirine,efavirenz,nevirapine,and lopinavir/ritonavir was 0.8%,0.3%,0.7%,1.0%,1.3%,2.8%,2.9%,and 0,respectively.Conclusions CRF01_AE,CRF07_BC,and CRF08_BC are the three major strains of HIV-infected men≥50 years old newly reported in Guangxi,2020,and the pretreatment drug resistance demonstrates low prevalence.

关 键 词：人类免疫缺陷病毒 基因亚型 治疗前耐药 

分 类 号：R18[医药卫生—流行病学]