2019—2022年北京某院HIV-1新发感染者抗病毒治疗前耐药情况分析  

Analysis of drug resistance in newly infected HIV-1 patients without antiviral therapy of hospital in Beijing from 2019 to 2022

作　　者：李莉[1] 安希钊 粟斌[1] 刘利锋[1] LI Li;AN Xizhao;SU Bin;LIU Lifeng(Beijing You′an Hospital,Capital Medical University,Beijing 100069,China)

机构地区：[1]首都医科大学附属北京佑安医院,北京100069

出　　处：《现代医药卫生》2024年第12期1990-1995,共6页Journal of Modern Medicine & Health

基　　金：国家重点研发计划“病原学与防疫技术体系研究”重点专项项目(2022YFC2305200)。

摘　　要：目的 了解2019—2022年该院新发1型人类免疫缺陷病毒(HIV-1)感染者中原发耐药水平和流行现状。方法 对2019—2022年HIV-1确认阳性且未行抗病毒治疗的新发感染者进行原发耐药检测。应用反转录/巢式聚合酶链式反应扩增病毒pol基因,进行病毒亚型、主要耐药相关突变和原发耐药率分析等。结果 2019—2022年新发HIV-1感染者进行原发耐药检测比例分别为62.23%(669/1 075)、80.00%(400/500)、 80.78%(500/619)及81.03%(474/585),原始耐药发生比例分别为5.31%(30/565)、6.65%(24/361)、6.59%(30/455)及4.19%(18/430),总耐药比例为5.63%(102/1 811)。蛋白酶抑制剂、核苷类反转录酶抑制剂(NRTIs)、非核苷类反转录酶抑制剂(NNRTIs)耐药率分别为0.11%(2/1 811)、1.44%(26/1 811)、4.91%(89/1 811);NNRTIs类耐药位点主要是V179D/E单独或与其他位点协同出现;NRTIs类耐药位点主要是M184V及K65R。主要感染亚型依次为CRF01_AE[44.56%(807/1 811)]、CRF07_BC[39.54%(716/1 811)]、B亚型[8.28%(150/1 811)]。结论 该院新诊断HIV-1感染者进行原发耐药检测比例逐年上升,近3年来原发耐药率呈下降趋势,原发耐药呈低流行水平,主要原发耐药为NNRTIs及NRTIs耐药。Objective To investigate the primary drug resistance level and epidemic status of newly inefcted human immunodeficiency virus(HIV-1)patients in this hospital from 2019 to 2022.Methods The primary drug resistance test was performed in newly infected HIV-1-positive patients who did not receive antiviral therapy from 2019 to 2022.The virus pol gene was amplified by reverse transcription/nested polymerase chain reaction,and the virus subtypes,major drug-resistant mutations and primary drug resistance rates were analyzed.Results From 2019 to 2022,the rates of primary drug resistance testing among newly infected HIV-1 patients were 62.23%(669/1075),80.00%(400/500),80.78%(500/619)and 81.03%(474/585),and the rates of primary drug resistance were 5.31%(30/565),6.65%(24/361),6.59%(30/455)and 4.19%(18/430),respectively,and the total rate of drug resistance was 5.63%(102/1811).The resistance rates of PIs,nucleoside reverse transcriptase inhibitors(NRTIs)and non-nucleoside reverse transcriptase inhibitors(NNRTIs)were 0.11%(2/1811),1.44%(26/1811)and 4.91%(89/1811),respectively.The major NNRTIs resistance sites were V179D/E alone or in concert with other sites.The main NRTIs resistance sites were M184V and K65R.The main subtypes were CRF01_AE[44.56%(807/1811)],CRF07_BC[39.54%(716/1811)],and subtype B[8.28%(150/1811)].Conclusion The proportion of newly diagnosed HIV-1 infected patients who underwent primary resistance testing in this hospital showed an increasing trend,and the primary resistance rate showed a decreasing trend in the past three years,primary resistance is still at a low prevalence level,and the main primary drug resistance were NNRTIs and NRTIs resistance.

关 键 词：艾滋病病毒 新发感染 亚型 原发耐药 核苷类反转录酶抑制剂 非核苷类反转录酶抑制剂 

分 类 号：R373.9[医药卫生—病原生物学]