2023年宁夏地区HIV-1耐药与分子传播网络特征分析  

Analysis of HIV-1 Drug Resistance and Molecular Transmission Network in Ningxia in 2023

作　　者：刘义昌 裴建新 马小发 司冰倩 马春花 李钰峰 朱晓虹 杨东智[2] 吴忠兰[2] LIU Yichang;PEI Jianxin;MA Xiaofa;SI Bingqian;MA Chunhua;LI Yufeng;ZHU Xiaohong;YANG Dongzhi;WU Zhonglan(School of Public Health,Ningria Medical University,Yinchuan 750004,China;Ningria Center for Disease Control and Prevention,Yinchuan750000,China)

机构地区：[1]宁夏医科大学公共卫生学院,银川750004 [2]宁夏疾病预防控制中心,银川750000

出　　处：《病毒学报》2024年第6期1384-1390,共7页Chinese Journal of Virology

基　　金：2017年宁夏青年拔尖人才项目(项目号:宁人社函发[2017]787号);2020年宁夏回国人员创新创业项目(项目号:宁人社函[2021]5号),题目:核酸定量检测在优化艾滋病一站式早期诊断中的应用。

摘　　要：分析2023年宁夏地区HIV/AIDS患者的基因型耐药情况、分子传播网络特征。选取2023年宁夏地区病毒载量>200copies/mL的HIV/AIDS患者的血浆样品进行扩增、测序和基因型耐药监测,判断基因亚型和耐药特征;使用MEGA11软件以TN93模型计算所有序列两两之间的基因距离,以0.013作为基因阈值在Cytoscape 3.9.1中构建分子传播网络。262例样本中亚型以CRF07_BC和CRF01_AE为主;88例发生耐药,总体耐药率为3.01%(88/2919),以NRTIs-NNRTIs双重耐药(13.74%,36/262)和NNRTIs单纯耐药(13.36%,35/262)为主;107条序列(40.84%,107/262)进入分子传播网络形成18个传播簇,以男性(82.24%,88/107)、26~49岁(58.88%,63/107)、居住于银川市(55.14%,59/107)、异性传播(69.16%,74/107)为主,7种亚型进入网络,CRF01_AE亚型数量最多(59.81%,64/107)。2023年宁夏地区HIV/AIDS患者基因亚型进一步多样化,耐药位点突变类型丰富,以NRTIs和NNRTIs耐药为主,可能已经发生跨地市耐药传播,HIV-1总体流行趋势具有一定聚集性,建议应加强地市间联合干预,结合流行病学资料与分子传播网络技术,识别快速扩张和耐药传播簇,减少HIV-1传播。This study aims to analyze the genotypic drug resistance and molecular transmission network characteristics of HIV-1 infected individuals in Ningxia in 2023.Plasma samples of HIV/AIDS patients with viral loads>200 copies/mL in Ningxia in 2023 were collected for amplification,sequencing,and genotypic drug resistance monitoring to determine genetic subtypes and drug resistance profiles.The MEGA11 software was used to calculate genetic distances between sequences using the TN93 model,and a genetic threshold of 0.013 was applied to construct a molecular transmission network in Cytoscape 3.9.1.The predominant subtypes among the 262 samples were CRF01_AE and CRF07_BC.A total of 88 sequences exhibited drug resistance,indicating an overall resistance rate of 3.01%(88/2919),with NRTIs-NNRTIs dual resistance(13.74%,36/262)and NNRTIs monoresistance(13.36%,35/262)being the most common forms.A total of 107 sequences(40.84%,107/262)were included in the molecular transmission network,forming 18 clusters,which were primarily composed of males(82.24%,88/107),individuals aged 26–49 years(58.88%,63/107),residents of Yinchuan City(55.14%,59/107),and those with heterosexual transmission(69.16%,74/107).Seven subtypes were identified in the network,with CRF01_AE being the most prevalent subtype(59.81%,64/107).In conclusion,the genetic subtype distribution of HIV-1 infected individuals in Ningxia in 2023 has become more diverse,with various mutations observed at drug resistance sites,primarily involving NRTIs and NNRTIs resistance.Cross-city transmission of drug resistance may have occurred,and the overall HIV-1epidemic trend exhibits some degree of clustering.It is recommended to strengthen joint interventions across cities,utilizing both epidemiological data and molecular transmission network technology to identify rapidly expanding and drug-resistant transmission clusters,thereby reducing HIV-1 transmission.

关 键 词：HIV-1 基因型耐药 分子传播网络 

分 类 号：R373.9[医药卫生—病原生物学]