杭州市HIV-1 CRF55_01B毒株耐药及分子网络分析  

Analysis of drug resistance and molecular network of HIV-1 CRF55_01B strains in Hangzhou

作　　者：叶灵 许珂[1] 罗文杰[1] 张兴亮[1] 吴嗣圣 朱敏 尤佳女 Ye Ling;Xu Ke;Luo Wenjie;Zhang Xingliang;Wu Sisheng;Zhu Min;You Jian(Institute for AIDS/STD Prevention and Treatment,Hangzhou Center for Disease Control and Prevention(Hangzhou Health Supervision Institution),Hangzhou 310002,China)

机构地区：[1]杭州市疾病预防控制中心(杭州市卫生监督所)艾滋病性病防制所,杭州310002

出　　处：《国际流行病学传染病学杂志》2024年第5期328-333,共6页International Journal of Epidemiology and Infectious Disease

基　　金：杭州市农业与社会发展科研引导项目(20220919Y062);杭州市医学重点学科(感染性疾病学);浙江省医药卫生科技计划(2023KY1001)。

摘　　要：目的了解杭州市新报告HIV/AIDS感染者CRF55_01B毒株耐药及分子网络特征。方法收集杭州市2019—2023年新确证且未经抗病毒治疗HIV/AIDS感染病例血样, 通过RT-PCR和巢式PCR扩增HIV-1pol基因并测序。使用MEGA7.0软件构建系统进化树判断亚型, 选取CRF55_01B亚型序列构建分子网络, 提交序列至斯坦福大学耐药数据库, 确定耐药突变位点及毒株对药物的敏感性。结果获得167条CRF55_01B感染者pol基因序列。167例HIV/AIDS感染者总体耐药率9.6%(16/167), 蛋白酶抑制剂(protease inhibitors, PIs)、核苷酸逆转录酶抑制剂(nucleostide reverse transcriptase inhibitors, NRTIs)和非核苷酸逆转录酶抑制剂(non-nucleoside reverse transcriptase inhibitors, NNRTIs)耐药率分别为1.8%(3/167)、0.6%(1/167)和7.2%(12/167);耐药以低度耐药为主(13例), NNRTIs类耐药位点主要是V179D/E与其他位点协同出现, 另有88.0%(147/167)单独携带V179D/E的感染者表现为潜在耐药。在最适基因距离阈值(0.014)下构建分子网络, 入网率为49.7%(83/167), 鉴别出22个簇。现住址分布网络图显示, 杭州市各地区均有入网病例, 形成1个以萧山区为主和1个均为临平区病例的较大簇。结论杭州市新报告HIV/AIDS感染者CRF55_01B亚型治疗前耐药达到中度流行水平, 毒株传播关系复杂, 存在需重点关注的聚集性传播簇。Objective:To understand the drug resistance and molecular network characteristics of CRF55_01B strains in newly reported HIV/AIDS patients in Hangzhou.Methods:The blood samples were collected from newly confirmed HIV/AIDS cases who had not received antiviral treatment in Hangzhou from 2019 to 2023.The HIV-1 pol gene was amplified and sequenced using RT-PCR and nested PCR.A phylogenetic tree was constructed using MEGA 7.0 software to determine the subtype.Sequences of the CRF55_01B subtype were used to construct a molecular network.The sequences were submitted to the Stanford University HIV Drug Resistance Database to identify drug-resistant mutation sites and drug sensitivity of the strains.Results:A total of 167 pol gene sequences from CRF55_01B-infected individuals were obtained.The overall drug resistance rate of 167 HIV/AIDS patients was 9.6%(16/167),with resistance rates for protease inhibitors(PIs),nucleoside reverse transcriptase inhibitors(NRTIs),and non-nucleoside reverse transcriptase inhibitors(NNRTIs)of 1.8%(3/167),0.6%(1/167),and 7.2%(12/167),respectively.Most cases exhibited low-level resistance(13 cases).NNRTI resistance was mainly associated with the V179D/E mutations in conjunction with other sites,and 88.0%(147/167)of those carrying the V179D/E mutation alone showed potential resistance.A molecular network was constructed at the optimal genetic distance threshold(0.014),resulting in a network inclusion rate of 49.7%(83/167)and identifying 22 clusters.A geographic distribution network indicated that cases were found across various districts of Hangzhou,forming a predominant cluster in Xianxia District and another in Linping District.Conclusions:The newly reported CRF55_01B strains among HIV/AIDS patients in Hangzhou exhibit a moderate prevalence of drug resistance before antiretrovial therapy.The strains have complex transmission relationships and the emergence of notable clusters requires further attention.

关 键 词：HIV-1 CRF55_01B 耐药 分子网络 

分 类 号：R446.5[医药卫生—诊断学] R512.91[医药卫生—临床医学]