北京地区MSM人群感染的HIV-1 CRF01_AE耐药及分子流行病学研究  

Genotypic drug resistance characteristics and molecular epidemiology study of HIV-1 CRF01_AE infected MSM population in Beijing

作　　者：李思飞 辛若雷[2] 肖明凤 庞灿 邓煜川 叶景荣[2] 卢红艳[2] 李洁[2] Li Sifei;Xin Ruolei;Xiao Mingfeng;Pang Can;Deng Yuchuan;Ye Jingrong;Lu Hongyan;Li Jie(School of Public Health,Capital Medical University,Beijing 100069,China;Institute for STD/AIDS Prevention and Treatment,Beijing Center for Disease Prevention and Control,Beijing 100013,China)

机构地区：[1]首都医科大学公共卫生学院,北京100069 [2]北京市疾病预防控制中心性病艾滋病防治所,100013

出　　处：《国际病毒学杂志》2024年第6期483-487,共5页International Journal of Virology

基　　金：北京市高层次公共卫生技术人才建设项目学科骨干项目(2022-3-025);北京市自然科学基金(L212057);国家自然科学基金(82003563)。

摘　　要：目的探究北京市MSM(men who have sex with men)人群中流行的HIV-1 CRF01_AE的耐药情况和基因进化特征。方法对2020—2022年在北京市艾滋病咨询检测门诊进行HIV初筛有反应的MSM人群进行HIV抗体免疫印迹检测和pol基因扩增检测。依据pol基因经COMET HIV-1进行分型,把分型为CRF01_AE的序列提交斯坦福HIV耐药数据库进行耐药分析,并用BEAST 1.10.4开展CRF01_AE基因进化特征研究。结果共招募到322例HIV初筛检测有反应人员,其中有243例(75.5%)感染者pol基因扩增检测阳性,对其进行Sanger法测序,剔除12条测序结果不佳的序列后,共获得231条序列,共有15种基因亚型,其中CRF01_AE(34.2%,79/231)和CRF07_BC(42.4%,98/231)是最主要亚型。CRF01_AE的传播性耐药发生率为6.3%,以PIs类药物最为常见(3.8%,3/79)。系统进化分析显示,北京地区MSM人群主要流行CRF01_AE的第四簇和第五簇,CRF01_AE的种群进化速率为2.09×10^(-3)(95%HPD,1.67~2.54),CRF01_AE种群规模持续增长。结论2020至2022年CRF01_AE亚型是北京地区MSM人群HIV感染的主要亚型之一。CRF01_AE传播性耐药率较高,应加强对传播性耐药的监测和防控。CRF01_AE种群规模较大,应关注CRF01_AE种群流行趋势,采取有效防控措施。Objective To investigate the drug resistance and genetic evolution characteristics of HIV-1 CRF01_AE which was prevalent in the population of men who have sex with men(MSM)in Beijing.Methods MSM individuals who visited the counseling and testing clinics and were reactive in HIV screening tests between 2020 and 2022 in Beijing were enrolled for western-blot assay of anti-HIV antibody and HIV pol gene amplification assay.The obtained sequences of HIV-1 pol gene were classified by COMET HIV-1.CRF01_AE sequences were submitted to the Stanford HIV Drug Resistance Database for drug resistance analysis.The analysis on evolutionary characteristics of CRF01_AE gene was conducted by BEAST 1.10.4.Results A total of 322 HIV screening reactive patients were recruited,of which 243(75.5%)were positive for pol gene amplification.After Sanger sequencing and exclusion of 12 sequences with poor results,231 sequences were obtained.The sequences belonged to 15 subgenotypes while CRF01_AE(34.2%,79/231)and CRF07_BC(42.4%,98/231)were the dominant types.The incidence of transmitted drug resistance was 6.3% while the resistance to protease inhibitor(PI)drugs was the most common(3.8%,3/79).Phylogenetic analysis showed that CRF01_AE clusters 4 and 5 were predominant in the MSM population in Beijing.The evolutionary rate of the CRF01_AE population was 2.09×10^(-3)(95%HPD,1.67-2.54).The size of CRF01_AE population expanded continuously.Conclusions From 2020 to 2022,the CRF01_AE subtype was one of the main HIV subgenotypes among MSM population in Beijing.A high incidence of transmitted drug resistance was observed.Efforts should be made to enhance the surveillance,prevention and control of the transmitted drug resistance.The CRF01_AE population remained large in size and should be concerned for the prevalence trend of the population as well as implementation of effective control measures.

关 键 词：HIV 耐药 系统进化分析 CRF01_AE 

分 类 号：R51[医药卫生—内科学]