上海市浦东新区中青年感染人群HIV-1分子流行特征及耐药情况分析  

Molecular epidemiologic characteristics and pretreatment drug resistance of HIV-1 in young and middle-aged first-diagnosed infections,2019–2021 in Pudong New Area,Shanghai

作　　者：汤琰[1,2] 郎晶晶 许秋利 傅惠琴 陈盼盼[1,2] 郝莉鹏 TANG Yan;LANG Jingjing;XU Qiuli;FU Huiqin;CHEN Panpan;HAO Lipeng(Pudong District Center for Disease Control and Prevention,Shanghai,200136,China;Pudong Institute of Prevention Medicine,Fudan University,Shanghai 200136,China;Children's Hospital of Soochow University,Suzhou 215025,China)

机构地区：[1]上海市浦东新区疾病预防控制中心,上海200136 [2]复旦大学浦东预防医学研究院,上海200136 [3]苏州大学附属儿童医院,江苏215025

出　　处：《中国公共卫生》2025年第2期223-228,共6页Chinese Journal of Public Health

基　　金：上海市卫生健康委员会面上项目(202040477);上海市浦东卫生系统优秀青年医学人才培养计划(PWRq2020-24)。

摘　　要：目的了解上海市浦东新区2019—2021年<50岁的中青年人群中未经抗病毒治疗的新确诊感染者/患者HIV-1分子流行病学特征及耐药情况,为艾滋病防治策略提供参考依据。方法收集2019—2021年浦东新区确诊实验室HIV-1抗体首次确诊阳性且人口学信息满足条件的347份<50岁人群血样本,采用反转录聚合酶链式反应(RT-PCR)扩增HIV-pol基因,进行治疗前耐药基因检测及HIV-1亚型检测。结果获取302例HIV-pol区基因全序列片段,HIV-1流行簇主要有CRF07_BC(40.40%)、CRF01_AE(36.09%)、CRF55_01B(8.28%);感染途径为同性性传播(72.52%)和异性性传播(27.48%);不同性传播途径的病毒亚型分布差异有统计学意义(P=0.003)。HIV-1耐药率为5.96%,低中高度耐药均有出现,其中NNRTIs、NRTIs、PIs分别为4.97%、0.66%、0.33%;不同亚型之间的耐药率差异有统计学意义(P=0.037)。结论上海市浦东新区2019—2021年中青年人群新确诊HIV-1感染者,基因亚型主要以CRF07_BC、CRF01_AE、CRF55_01B为主,但已出现新的重组毒株,呈现多元化发展趋势,且在多种亚型中出现不同程度的治疗前耐药。Objective To investigate the molecular epidemiological characteristics and drug resistance of HIV-1among newly diagnosed antiretroviral therapy(ART)-naive infected individuals aged<50 years in Pudong New Area,Shanghai,2019–2021,and to provide evidence to refine local HIV prevention and control strategies.Methods Blood samples(n=374)were collected from individuals newly diagnosed with HIV infection between 2019 and 2021.Inclusion criteria were as follows:(1)confirmed first-time HIV-positive diagnosis by Western blot and without prior ART,(2)age less than 50 years,(3)voluntary participation,and(4)current residence or employment in Pudong New Area.Exclusion criteria were:(1)unsuccessful RNA extraction or sequencing,(2)mixed bases in the HIV-pol region sequence≥5%,and(3)sequences shorter than 1000 base pairs.The HIV-1 pol gene was amplified by reverse transcription-polymerase chain reaction(RT-PCR)for both pretreatment drug resistance genotyping and HIV-1 subtype determination,with subsequent analysis using the Stanford University HIV Drug Resistance Database for 302 successfully sequenced samples.Demographic and epidemiologic data were collected through structured in-person interviews.Results A total of 13 HIV-1 subtypes and unique recombinant forms(URFs)were identified among the 302 sequenced samples,of which 72.52%were from homosexual and 27.48%from heterosexual infections.The predominant strains were CRF07_BC(40.40%),CRF01_AE(36.09%)and CRF55_01B(8.28%).A significant variance in the distribution of viral subtypes was observed among individuals infected by different sexual transmission routes(χ2=22.161,P=0.003).However,the distribution of the prevalent strains CRF01_AE,CRF07_BC and CRF55_01B did not differ significantly between homosexual and heterosexual transmission(χ2=4.854,P=0.088),nor among the three age groups 15–24,25–34 and 35–49 years(χ2=1.383,P=0.847).Resistance analysis showed a resistance rate of 5.96%in this population,with resistance levels ranging from low to intermediate to high.Non-nu

关 键 词：艾滋病病毒(HIV-1) 中青年人群 HIV-pol基因 基因亚型 上海市浦东区 

分 类 号：R51[医药卫生—内科学]