2023年河南省人类免疫缺陷病毒1型感染者治疗前耐药特征分析  

Characteristics of pretreatment drug resistance mutations in people living with human immunodeficiency virus type 1 in Henan Province,2023

作　　者：刘金瑾 赵清霞 张晓华[3] 位曙光 霍玉奇[1] Liu Jinjin;Zhao Qingxia;Zhang Xiaohua;Wei Shuguang;Huo Yuqi(Translational Research Center,Affiliated Infectious Diseases Hospital of Zhengzhou University(Henan Infectious Diseases Hospital,The Sixth People′s Hospital of Zhengzhou),Zhengzhou 450000,China;Infectious Diseases Department,Affiliated Infectious Diseases Hospital of Zhengzhou University(Henan Infectious Diseases Hospital,The Sixth People′s Hospital of Zhengzhou),Zhengzhou 450000,China;Infectious Diseases and Immunology Clinic,Affiliated Infectious Diseases Hospital of Zhengzhou University(Henan Infectious Diseases Hospital,The Sixth People′s Hospital of Zhengzhou),Zhengzhou 450000,China)

机构地区：[1]郑州大学附属传染病医院(河南省传染病医院,郑州市第六人民医院)转化医学研究中心,郑州450000 [2]郑州大学附属传染病医院(河南省传染病医院,郑州市第六人民医院)感染科,郑州450000 [3]郑州大学附属传染病医院(河南省传染病医院,郑州市第六人民医院)感染与免疫门诊,郑州450000

出　　处：《中华传染病杂志》2024年第6期338-343,共6页Chinese Journal of Infectious Diseases

基　　金：河南省医学科技攻关项目(232102310203)。

摘　　要：目的监测河南省2023年未接受抗反转录病毒治疗(ART)的人类免疫缺陷病毒(HIV)-1感染者HIV-1基因亚型分布和治疗前耐药突变情况,为了解河南省HIV-1耐药株传播和制订ART方案提供数据支持。方法收集2023年1月至12月于郑州市第六人民医院就诊的未接受ART的HIV-1感染者的临床资料和耐药情况。本研究为横断面研究。采集患者血浆样本,通过反转录-巢式聚合酶链反应扩增HIV-1部分pol区基因序列及整合酶基因序列。通过REGA HIV-1亚型分析工具确定HIV-1分离株的亚型,使用美国斯坦福大学HIV耐药数据库对其基因耐药突变和抗病毒药物敏感性进行分析。结果1073例未接受ART的HIV-1感染者中,1042例患者的样本被成功扩增,扩增成功率为97.11%,共检测到12种HIV基因亚型,构成比前5位的亚型依次为流行重组型(CRF)07BC[43.76%(456/1042)]、CRF01AE[25.91%(270/1042)]、B[20.92%(218/1042)]、CRF5501B[5.28%(55/1042)]和CRF08BC[1.25%(13/1042)]。HIV-1感染者ART前总耐药突变率为28.89%(301/1042)。其中非核苷类反转录酶抑制剂(NNRTI)耐药突变率为20.92%(218/1042),核苷类反转录酶抑制剂(NRTI)为4.03%(42/1042),蛋白酶抑制剂(PI)为3.84%(40/1042),整合酶抑制剂(INSTI)为2.98%(31/1042)。V179位点[12.96%(135/1042)]是最常见的NNRTI相关突变位点,M184位点[2.40%(25/1042)]是最常见的NRTI相关突变位点,Q58[2.78%(29/1042)]和E157[1.44%(15/1042)]位点分别在PI和INSTI相关突变位点中最为常见。结论河南省未接受ART的HIV-1感染者基因亚型分布呈多样化,耐药率呈中度流行水平,应继续加强ART前耐药的密切监测。Objective To monitor the subtype distributions and drug resistance mutations of human immunodeficiency virus(HIV)-1 in people living with human immunodeficiency virus-1(PLWH)who had not experienced anti-retroviral therapy(ART)in Henan Province in 2023,so as to provide valuable data for understanding the transmission of HIV-1 resistant strains and selection of ART regimens in Henan Province.Methods The clinical data and drug resistance of PLWHs who had not experienced ART in the Sixth People′s Hospital of Zhengzhou from January to December 2023 were collected.This study was a cross-sectional study.Plasma samples were collected from patients,and the partial HIV pol gene sequence and the full integrase gene sequence were amplified by reverse transcription-nested polymerase chain reaction.The subtypes of HIV-1 isolates were determined using the online REGA HIV-1 Subtyping Tool.Drug resistance mutations and antiviral drug susceptibility were analyzed by submitting the determined sequences to the Stanford HIV-1 drug resistance database.Results Among the 1073 PLWHs who had not experienced ART,sequences in 1042 were successfully amplified,giving a success rate of 97.11%.A total of 12 subtypes were detected,and the top five subtypes were circulating recombinant form(CRF)07_BC(43.76%,456/1042),CRF01_AE(25.91%,270/1042),B(20.92%,218/1042),CRF55_01B(5.28%,55/1042)and CRF08_BC(1.25%,13/1042).The incidence of drug resistance mutation was 28.89%(301/1042).Drug resistance mutation of non-nucleoside reverse transcriptase inhibitors(NNRTI),nucleotide reverse transcriptase inhibitors(NRTI),protease inhibitors(PI)and integrase inhibitors(INSTI)were 20.92%(218/1042),4.03%(42/1042),3.84%(40/1042)and 2.98%(31/1042),respectively.V179(12.96%,135/1042),M184(2.40%,25/1042),Q58(2.78%,29/1042),and E157(1.44%,15/1042)were the most common drug resistance mutation for NNRTIs,NRTIs,PIs and INSTIs,respectively.Conclusions The distribution of HIV-1 subtypes is diverse,and the incidence of drug resistance mutation is moderate prevalent in PLWHs w

关 键 词：人类免疫缺陷病毒 抗逆转录病毒治疗 治疗前耐药突变 基因亚型 

分 类 号：R512.9[医药卫生—内科学]