甘肃省部分地区2020-2021年新报告HIV/AIDS患者治前耐药及分子传播网络特征分析  

Characteristics of the pretreatment drug resistance and molecular transmission network in newly reported HIV infections in some areas of Gansu Province from 2020 to 2021

作　　者：乔瑞娟[1] 张林才[1] 冯毅[2] 屠爱霞[1] 王晓蕊[1] 石林[1] 蔺续霞 QIAO Ruijuan;ZHANG Lincai;FENG Yi;TU Aixia;WANG Xiaorui;SHI Lin;LIN Xuxia(Gansu Center for Disease Control and Prevention,Lanzhou 730020,Gansu,China;National Center for AIDS/STD Control and Prevention,National Center for Disease Control and Prevention of China,Beijing 102206,China)

机构地区：[1]甘肃省疾病预防控制中心,兰州730020 [2]中国疾病预防控制中心性病艾滋病预防控制中心,北京102206

出　　处：《中国艾滋病性病》2023年第8期860-865,共6页Chinese Journal of Aids & STD

基　　金：2020年甘肃省卫生行业科研计划项目(GSWSKY2020-22);2020年甘肃省第十批省级科技计划项目(20JR10RA418)。

摘　　要：目的分析甘肃省部分地区新报告HIV/AIDS患者分子传播网络特征,为精准干预相关人群中HIV-1传播提供实验室依据。方法反转录和巢式PCR扩增样本pol区基因并测序,采用MEGA 7.0软件构建系统进化树分析亚型,通过美国斯坦福大学HIV耐药数据库在线软件工具分析耐药突变位点,Hyphy和Cytoscape 3.9.1软件生成分子网络,Logistic回归模型对入网率的影响因素进行分析。结果收集甘肃省部分地区2020-2021年新报告病例血浆样本331份,成功获得pol区基因序列303条,共发现11种亚型和流行重组型,主要为CRF07_BC(58.1%)、CRF01_AE(21.1%)、B(6.9%)和CRF55_01B(5.3%)。治疗前耐药率为4.0%,NNRTI类耐药率最高为3.3%,主要耐药位点是K103 N/S(1.7%)。分子网络最适基因距离为1.2%,在此基因距离时共形成33个分子簇,91条序列入网,入网率为30.0%。对进入网络的影响因素进行分析,多因素Logistic回归结果显示,CRF07_BC(与CRF01_AE相比)、河西地区(与陇东南地区相比)更容易进入网络。结论甘肃省部分地区新报告HIV/AIDS患者治疗前耐药率仍处低水平。HIV-1分子传播簇内的毒株呈现地区聚集性,应加强性伴追踪和针对性干预,有效遏制艾滋病的传播。Objective To analyze the molecular epidemic characteristics and transmission network of newly reported HIV cases in several prefectures of Gansu Province from 2020-2021,to provide a laboratory basis for accurate intervention for HIV-1 control and prevention.Methods RT-PCR and nPCR were used to amplify the pol gene and sequenced by the Sanger method.The phylogenetic tree was constructed to analyze the molecular transmission network for subtypes by MEGA 7.0,Hyphy,and Cytoscape 3.9.1.Drug resistance mutation analysis was performed using Stanford University Drug Resistance Database.Associated factors of entering the network were analyzed using Logistic regression.Results 331 plasma samples of newly reported HIV cases in several prefectures of Gansu Province from 2020 to 2021 were collected.303 pol gene sequences including 11 subtypes and CRF were obtained successfully.The main types were CRF07_BC(58.1%),CRF01_AE(21.1%),B(6.9%),and CRF55_01B(5.3%).The overall pretreatment drug resistance rate was 4.0%.The highest drug resistance rate was 3.3%for NNRTI,and the main drug resistance sites were K103 N/S(1.7%).Molecular transmission networks were constructed using 1.2%as the gene distance threshold.With 91 sequences,a total of 33 molecular clusters were formed,resulting in a clustering rate of 30.0%.Multivariate logistic regression showed that people with CRF07_BC mutation(compared with CRF01_AE)and living in the western region(compared with the Southeast)were more likely to enter the network.Conclusions The transmitted drug resistance level of newly reported HIV infection in Gansu Province is still low.By constructing molecular transmission networks,the geographical distribution of cluster cases is relatively centralized.To effectively control the spread of AIDS,the targeted interventions for those sexual partners involved should be strengthened.

关 键 词：艾滋病病毒 耐药 分子传播网络 

分 类 号：R373.9[医药卫生—病原生物学]