2021年贵阳市HIV-1感染者基因亚型及耐药分析  

Analysis of gene subtypes and drug resistance of HIV-1 infected individuals in Guiyang city in 2021

作　　者：覃达文 洪章萍 蒙楠 王艺 沈渡 胡勇[1] 杨兴林 QIN Dawen;HONG Zhangping;MENG Nan;WANG Yi;SHEN Du;HU Yong;YANG Xinglin(School of Public Health and Wellness,Guizhou Medical University,Guiyang,Guizhou 561113,China;不详)

机构地区：[1]贵州医科大学公共卫生与健康学院,贵州贵阳561113 [2]贵阳市公共卫生救治中心检验科,贵州贵阳550004

出　　处：《中国病毒病杂志》2024年第2期176-181,共6页Chinese Journal of Viral Diseases

基　　金：贵阳市科技计划项目(筑科合同[2018]1-40号)。

摘　　要：目的选取贵阳市公共卫生救治中心接受抗反转录病毒治疗(antiretroviral treatment,ART)前的人类免疫缺陷病毒1型(human immunodeficiency virus type 1,HIV-1)感染者进行基因亚型及耐药研究,为贵阳市艾滋病防治工作提供科学依据。方法收集贵阳市公共卫生救治中心2021年1月1日—12月30日接受ART前的HIV-1感染者160例,采集HIV-1感染者外周静脉血样本,通过巢式聚合酶链反应(polymerase chain reaction,PCR)扩增HIV-1 pol区基因,采用Sanger法进行测序。使用HIVdb Program在线工具进行耐药突变分析,采用Fisher确切概率法对调查对象人口学特征、基因亚型分布及耐药情况进行分析。结果160份HIV感染者样本中成功扩增得到143条基因序列。11例HIV感染者发生ART前耐药,耐药率为7.69%(11/143)。HIV-1感染者存在6种基因亚型,以CRF07_BC和CRF01_AE亚型为主,分别占46.85%(67/143)、32.87%(47/143),其次为CRF08_BC亚型(15.38%,22/143)、B亚型(2.10%,3/143)、C亚型(1.40%,2/143)和CRF55_01B亚型(1.40%,2/143);性传播途径为主,占已知传播途径的97.20%(139/143)。HIV-1基因亚型以非核苷类反转录酶抑制剂(non-nucleoside reverse transcriptase inhibitors,NNRTIs)耐药为主,其中E138A(5/143)和K103N(4/143)位点突变率较高;HIV-1感染者存在NNRTIs及蛋白酶抑制剂(protease inhibitors,PIs)交叉耐药。结论2021年,性传播是导致贵阳市HIV-1感染者基因亚型多样性的重要原因,HIV毒株处于中度耐药水平,应持续加强HIV感染者耐药监测,预防耐药毒株的传播。Objective To study the genetic subtypes and drug resistance of human immunodeficiency virus type 1(HIV-1)infected individuals before receiving antiretroviral treatment(ART)at Guiyang Public Health Treatment Center,and to provide scientific basis for HIV/AIDS prevention and treatment in Guiyang.Methods A total of 160 HIV-1 infected individuals who hadn't receive ART during January 1,2021,to December 30,2021,at the Guiyang Public Health Treatment Center were included.HIV-1 pol region gene was amplified by nested polymerase chain reaction(PCR).Sanger method was used for sequencing,and HIVdb Program online tool was used for drug resistance mutation analysis.Fisher's exact probability method was used to analyze demographic characteristics,distribution of genetic subtypes,and drug resistance.Results A total of 143 gene sequences were successfully obtained from 160 samples,and 11 cases showed drug resistance before ART,with a resistance rate of 7.69%(11/143).Six genetic subtypes of HIV-1 were identified,with CRF07_BC and CRF01_AE subtypes being the predominant subtypes,accounting for 46.85%(67/143)and 32.87%(47/143)respectively,followed by CRF08_BC accounting for 15.38%(22/143),B accounting for 2.10%(3/143),C accounting for 1.40%(2/143),and CRF55_01B accounting for 1.40%(2/143).The transmission of genetic subtypes was mainly through sexual transmission,accounting for 97.20%(139/143)of the population with known transmission routes.The HIV-1 gene subtypes were mainly resistant to non-nucleoside reverse transcriptase inhibitors(NNRTIs),with higher rates of site mutations in E138A(5/143)and K103N(4/143).HIV-1-infected individuals exhibited cross-resistance to NNRTIs and protease inhibitors(PIs).Conclusions The sexual transmission routes in the Guiyang city in 2021 are an important source of HIV-1 gene subtype diversity,and the drug resistance rate of strains is at a moderate level.Continuous strengthening of drug resistance monitoring is necessary to prevent the spread of drug-resistant strains.

关 键 词：人类免疫缺陷病毒-1 基因亚型 性传播 耐药 耐药突变 

分 类 号：R512.91[医药卫生—内科学]