合肥市新报告HIV-1感染者传播性耐药特征及分子传播网络研究  

Study on the characteristics of transmitted durg resistance and molecular transmission network in newly reported HIV-1 infected individuals in Hefei city

作　　者：刘家敏 潘文婷 姚晖[3] 王海[3] 类延花[3] 胡中旺[3] 沈月兰[4] 方琴 张进[4] 戴色莺[4] 帅晨曦 金琳[4] 刘爱文[4] 秦义组[4] 缪礼锋[4] 石玉 吴建军 Liu Jiamin;Pan Wenting;Yao Hui;Wang Hai;Lei Yanhua;Hu Zhongwang;Shen Yuelan;Fang Qin;Zhang Jin;Dai Seying;Shuai Chenxi;Jin Lin;Liu Aiwen;Qin Yizu;Miao Lifeng;Shi Yu;Wu Jianjun(School of Public Health,Anhui Medical University,Hefei 230032,China;Anhui No.2 Provincial People’s Hospital,Hefei 230041,China;Hefei Center for Disease Control and Prevention,Hefei 230091,China;Anhui Provincial Center for Disease Control and Prevention,Hefei 230601,China)

机构地区：[1]安徽医科大学公共卫生学院,合肥230032 [2]安徽省第二人民医院,合肥230041 [3]合肥市疾病预防控制中心,230091 [4]安徽省疾病预防控制中心,合肥230601

出　　处：《国际病毒学杂志》2023年第4期276-280,共5页International Journal of Virology

基　　金：2022年度安徽省卫生健康科研项目(AHWJ2022b057)。

摘　　要：目的研究安徽省合肥市2020年新报告HIV-1感染者的传播性耐药(transmitted drug resistance,TDR)及分子传播网络情况。方法收集合肥市2020年1—12月新报告HIV-1感染者,扩增pol基因区(2253~3314 nt),判定基因型耐药情况,构建分子传播网络并分析进入网络病例的相关特征。结果成功扩增pol基因区序列376条,主要的毒株为CRF07BC(157,41.8%)和CRF01AE(136,36.2%)。新报告感染者TDR为2.7%(10/376),10例携带监测性耐药突变(surveillance drug resistance mutation,SDRM),并且毒株CRF5501B所占比例较大(4/10)。分别以0.5%作为基因距离阈值构建了分子传播网络,CRF01AE的大型网络以已婚中年男男性行为者(men who have sex with men,MSM)为主,而CRF07BC则以教育水平较高的未婚MSM为主。通过logistic回归分析入网的影响因素发现CD4细胞计数在200~500个/μL者(aOR=3.219,95%CI:1.226~8.452)与CD4细胞计数>500个/μL者(aOR=5.375,95%CI:1.664~17.364)更易进入网络。结论合肥地区2020年新报告HIV-1感染人群以中青年MSM为主,TDR较低,但要加强CRF5501B的耐药监测。Objective To study the transmitted drug resistance(TDR)and molecular transmission network of newly reported HIV-1 infected patients in Hefei city,Anhui province in 2020.Methods Newly reported HIV-1 infected patients in Hefei city from January to December 2020 were collected.The pol gene region(2253-3314 nt)was amplified to determine the genotypic drug resistance.The molecular transmission network was constructed and the characteristics of the cases entering the network were analyzed.Results A total of 376 pol gene region sequences were successfully amplified.The dominant strains were CRF07_BC(160,42.6%)and CRF01_AE(136,36.2%).The TDR of newly reported infected patients was 2.7%(10/376).Ten cases carried surveillance drug resistance mutations(SDRM),and the proportion of CRF55_01B strains among the cases was relatively large(4/10).Molecular transmission networks were constructed with a genetic distance threshold of 0.5%.The large network of CRF01_AE was mainly composed of married middle-aged men who have sex with men(MSM),while CRF07_BC network was mainly composed of highly educated unmarried MSM.Logistic regression analysis found that the patients with CD4 cell counts of 200-500 cells/μL(aOR=3.219,95%CI:1.226-8.452)and>500 cells/μL(aOR=5.375,95%CI:1.664-17.364)were more likely to enter the network.Conclusions In Hefei area in 2020,newly reported HIV-1 infected patients were mainly young and middle-aged MSM with relatively low TDR,but it is necessary to strengthen the drug resistance surveillance of CRF55_01B.

关 键 词：人类免疫缺陷病毒1型 男男性行为者 分子传播网络 传播性耐药 传播簇 

分 类 号：R512.91[医药卫生—内科学]