北京市通州区2021—2022年新报告HIV-1感染者基因分型与耐药情况  

Genetic subtypes and drug resistance characteristics of newly reported HIV-1 cases in Tongzhou District, Beijing, 2021-2022

作　　者：高洁 高翔[1] 周景林[1] 邹林[1] 李震[1] 温祁 王芳[1] GAO Jie;GAO Xiang;ZHOU Jinglin;ZOU Lin;LI Zhen;WEN Qi;WANG Fang(Tongzhou Center for Disease Control and Prevention,Beijing 101100,China)

机构地区：[1]北京市通州区疾病预防控制中心,北京101100

出　　处：《中国热带医学》2025年第2期204-210,共7页China Tropical Medicine

基　　金：北京市通州区科技计划项目(No.KJ2022CX078)。

摘　　要：目的 了解北京市通州区2021—2022年新报告HIV-1感染者HIV-1基因型分布特点,分析该地区HIV-1分子流行特征与耐药情况。方法 以北京市通州区2021—2022年新报告HIV-1感染者为研究对象,采用巢式PCR扩增HIV-1 pol区基因,经一代测序后获得基因序列,构建系统进化树并对HIV-1基因亚型与耐药情况进行分析。结果 北京市通州区2021—2022年新报告HIV-1感染者308例,共获得230条HIV-1 pol区基因序列,病例覆盖率74.68%;发现7种HIV-1基因型,以CRF07_BC(42.17%)和CRF01_AE(36.09%)为主要流行株,且存在CRF55_01B、CRF01_AE和BC重组等新型重组型;不同年龄组、检测途径的新报告HIV-1感染者基因型构成比差异有统计学意义(χ^(2)=17.845,P<0.05;χ^(2)=7.731,P<0.05);性别、传播途径、婚姻状况等因素对基因型构成比影响差异无统计学意义(P>0.05)。共64例(27.83%)出现耐药突变,累计出现27种突变位点;不同HIV-1基因型耐药相关突变率差异有统计学意义(χ^(2)=53.674,P<0.05),CRF55_01B突变率最高(100.0%)。共18例(7.83%)出现不同程度耐药,对蛋白酶抑制剂(protease inhibitors,PIs)、核苷类逆转录酶抑制剂(nucleoside reverse transcriptase inhibitors, NRTIs)、非核苷类逆转录酶抑制剂(non-nucleoside reverse transcriptase inhibitors, NNRTIs)耐药率分别为3.04%、0.87%、4.35%;高度耐药8例,1例为NRTIs耐药,突变位点为M184V;其余均为NNRTIs耐药,涉及位点包括M184V、K103N、Y188L及Y188C等。结论 北京市通州区2021—2022年新发HIV-1基因型多样,以CRF07_BC与CRF01_AE为优势毒株;总原发性耐药率达中等水平。应加强HIV-1基因型分析与耐药监测,重点关注独特重组型与耐药基因突变。Objective To investigate the distribution characteristics of genetic subtypes among newly reported human immunodeficiency virus type 1(HIV-1)cases in Tongzhou District,Beijing,from 2021 to 2022,and to analyze the molecular epidemiological characteristics and drug resistance patterns of HIV-1 in the area.Methods Newly reported HIV-1 cases in Tongzhou District,Beijing,from 2021 to 2022,were taken as the study population.Nested PCR was used to amplify the HIV-1 pol region gene,and the gene sequences were obtained through first-generation sequencing.A phylogenetic tree was constructed to analyze the HIV-1 genetic subtypes and drug resistance.Results There were 308 new HIV-1 cases reported in Tongzhou District,Beijing from 2021 to 2022.A total of 230 HIV-1 pol region gene sequences were obtained,with a case coverage rate of 74.68%.Seven HIV-1 genotypes were identified,with CRF07_BC(42.17%)and CRF01_AE(36.09%)being the main prevalent strains.Furthermore,new epidemic types such as CRF55_01B,CRF01_AE,and BC recombinants were detected.There were statistically significant differences(χ^(2)=17.845,P<0.05;χ^(2)=7.731,P<0.05)in the genotype composition ratio among newly reported HIV-1 cases across different age groups and detection routes,while no significant differences(P>0.05)were observed concerning gender,transmission route,marital status,and others.A total of 64 cases(27.83%)showed drug-resistant mutations,with 27 mutation sites identified in total.There were significant differences(χ^(2)=53.674,P<0.05)in the mutation rates among different HIV-1 genotypes,with the highest mutation rate(100.0%)observed in CRF55_01B.Drug resistance to PIs,NRTIs,and NNRTIs was observed in 18 cases(7.83%),with resistance rates of 3.04%,0.87%,and 4.35%,respectively.High-level drug resistance was observed in eight cases,including one case of NRTI resistance(mutation site M184V)and the remainder exhibiting NNRTI resistance,involving sites such as M184V,K103N,Y188L,and Y188C.Conclusions The genotype of HIV-1 in Tongzhou District is diverse,wi

关 键 词：人免疫缺陷病毒 基因型 耐药突变 耐药现状 北京 

分 类 号：R512.91[医药卫生—内科学]