2021年宁夏抗病毒治疗失败HIV/AIDS患者耐药传播网络特征分析  

Characteristics of Drug Resistance Transmission Network Among HIV/AIDS Patients Failing Antiviral Therapy in Ningxia,China,in 2021

作　　者：司冰倩 马春花 刘义昌 马小发 杨东智[2] 李龙山 吴忠兰[2] 张银豪[2] SI Bingqian;MA Chunhua;LIU Yichang;MA Xiaofa;YANG Dongzhi;LI Longshan;WU Zhonglan;ZHANG Yinhao(School of Public Health and Management,Ningria Medical University,Yinchuan 750004,China;Ningria Center for Disease Control and Prevention,Yinchuan 750000,China;Key Laboratory of Environmental Factors and Chronic Disease Control,Yinchuan 750004,China)

机构地区：[1]宁夏医科大学公共卫生与管理学院,银川750004 [2]宁夏疾病预防控制中心,银川750000 [3]宁夏环境因素与慢性病控制重点实验室,银川750004

出　　处：《病毒学报》2023年第5期1306-1313,共8页Chinese Journal of Virology

基　　金：2017年宁夏青年拔尖人才项目(证书号:RQ0126);2020年宁夏回国人员创新创业项目(证书号:宁人社函【2021】5号),题目:核酸定量检测在优化艾滋病一站式早期诊断中的应用~~。

摘　　要：分析宁夏2021年抗病毒治疗失败患者人类免疫缺陷病毒1型(Human immunodeficiency virus type 1,HIV-1)耐药传播网络特征。选取2021年宁夏地区病毒载量>1000拷贝/mL的HIV/AIDS患者的血浆样品进行基因型耐药监测,判断基因亚型和耐药特征;运用HyPhy 2.2.4中TN93模型计算基因距离,以1.5%作为阈值,利用Cytoscape 3.7.0构建并生成可视化分子传播网络。168例抗病毒治疗失败患者中,毒株亚型以CRF07_BC亚型和CRF01_AE亚型为主,耐药比例为39.88%,NNRTIs耐药突变高于NRTIs和PIs。62条序列进入HIV-1分子网络,形成24个分子簇,成簇率为36.90%,成簇病例以男性、异性传播和感染CRF07_BC亚型为主,CRF01_AE亚型耐药传播率最高(53.85%)。2021年宁夏抗病毒治疗失败患者基因亚型主要为CRF07_BC和CRF01_AE,耐药突变以NNRTIs/NRTIs为主,在传播网络中CRF07_BC亚型和MSM人群成簇比例更高,更容易被纳入网络,而CRF01_AE亚型的耐药传播风险更大,建议对抗病毒治疗失败患者加强耐药监测,及时更换治疗方案。To analyze the transmission network characteristics of human immunodeficiency virus type 1(HIV-1)resistance among patients with failed antiviral therapy in 2021 in Ningxia,China.Plasma samples of HIV/AIDS patients with viral load 1000copies/mL were selected for genotypic drug resistance test to determine genotypes and drug resistance characteristics in Ningxia,China in 2021.The gene distance calculated using TN93 model by HyPhy 2.2.4.Cytoscape 3.7.0 was used to construct and generate the visual molecular transmission network with 1.5%as the threshold.Among 168 patients with failed antiviral therapy,CRF07_BC subtype and CRF01_AE subtype were main subtypes.The drug resistance rate was 39.88%,and the drug resistance mutation rate of NNRTIs was higher than that of NRTIs and PIs.62 patients(36.90%)were included in the transmission network,and 24 clusters were identified.Cluster cases were mainly male,heterosexual transmission and infected with CRF07_BC subtype.The drug-resistant transmission rate of CRF01_AE subtype was the highest(53.85%).In 2021,the gene subtypes of patients with failed antiviral therapy in Ningxia,China were mainly CRF07_BC and CRF01_AE,and the drug resistance mutations were mainly NNRTIs/NRTIs.The CRF07_BC subtype and MSM population in the transmission network were more susceptible to HIV infection,while CRF01_AE subtype had a greater risk of drug resistance transmission.It is suggested to monitor drug resistance in patients with failed antiviral therapy and adjust antiviral therapy regimen in time.

关 键 词：HIV-1 抗病毒治疗 耐药 分子网络 

分 类 号：R512.91[医药卫生—内科学]