摘要
目的了解云南、四川、广东、广西壮族自治区和新疆维吾尔自治区等五个地区人类免疫缺陷病毒(human immunodeficiency virus, HIV)感染孕产妇体内毒株基因亚型及耐药情况。方法选取2016年6月—2019年6月229例未接受抗逆转录病毒治疗(antiretroviral therapy treatment, ART)的孕产妇HIV感染者产时外周血血浆,提取HIV-1核糖核酸(RNA),通过巢式聚合酶链式反应扩增HIV蛋白酶区(PR)、反转录酶区(RT)并测序。根据基因测序结果进行基因亚型和耐药突变位点以及抗病毒药物耐药情况的分析。结果 229例未经ART的HIV感染孕产妇血浆成功扩增197例,CRF07BC亚型87例(44.16%)、CRF08BC亚型56例(28.43%)、CRF01AE亚型44例(22.34%)、特殊重组亚型9例(4.57%)以及CRF85BC1例(0.51%)。其中16例发生耐药,耐药率为8.12%(16/197),22例含有耐药突变位点。发生核苷类反转录酶抑制剂(nucleotide reverse transcriptase inhibitor, NRTIs)、非核苷类反转录酶抑制剂(non-nucleoside reverse transcri ptase inhibitors, NNRTIs)、蛋白酶抑制剂(protease inhibitor, PIs)耐药突变频数分别为4例、18例和1例,其中有1例出现NRTIs和NNRTIs的双重耐药突变位点。耐药位点与HIV基因分型差异有统计学意义(P<0.01),考虑耐药突变存在亚型特异性。结论我国HIV感染的孕产妇人群中HIV基因亚型呈多样性。该人群传播性耐药率已经高于WHO耐药监测阈值,其耐药传播情况属中度流行水平,不同基因型耐药情况存在差异性。应该加强对该重点人群的耐药监测,为母婴阻断提供更加科学有效的抗病毒治疗措施。
Objective To describe the gene subtypes and drug resistance of HIV strains isolated from infected pregnant women in Yunnan, Sichuan, Guangdong, Guangxi Zhuang Autonomous Region and Xinjiang Uygur Autonomous Region. Methods From June 2016 to June 2019, plasma samples were collected from 229 HIV-infected pregnant women during delivery who never received ART, and HIV-1 RNA was extracted.The protease region(PR) and reverse transcriptase region(RT) of HIV-1 were amplified using nested polymerase chain reaction and were then sequenced.Gene subtypes, drug resistance mutation sites and antiviral drug resistance were analyzed. Results The PR and RT region of HIV-1 gene were successfully amplified from 197 cases with the most common gene subtype of CRF07BC(44.16%), followed by CRF08BC(28.43%), CRF01AE(22.34%), CRF01 B(4.57%) and CRF85BC1(0.51%).The drug resistance rate was 8.12% and 22 were identified of having drug resistant mutation loci.The mutation of nucleoside reverse transcriptase inhibitors(NRTIs), non-nucleoside reverse transcriptase inhibitors(NNRTIs) and protease inhibitors(PIs)were identified in 4 cases,18 cases and 1 case,respectively,one case had both NRTIs and NNRTIs mutations.The difference was statistically significant between drug resistance mutation loci and HIV genotyping(P<0.01),indicating a subtype specificity of drug resistance mutation. Conclusions HIV gene subtypes are diverse among infected pregnant women in provinces with high incidence of HIV/AIDS in China.The rate of transmissible drug resistance in this population is above WHO′s drug resistance monitoring threshold,causing a moderate epidemic level of transmition.The drug resistance varies among different genotypes.Therefore,the surveillance for drug-resistance of HIV should be strengthened to provide more effective antiviral treatment measures for mother-to-child blocking.
作者
邓煜川
徐晴晴
朱禹静
李珍
王爱玲
姚均
DENG Yu-chuan;XU Qing-qing;ZHU Yu-jing;LI Zhen;WANG Ai-ling;YAO Jun(Center for STD and AIDS Prevention and Control,Chinese Center for Disease Control and Prevention,Beijing 102206,China;不详)
出处
《中国预防医学杂志》
CAS
CSCD
北大核心
2021年第1期23-27,共5页
Chinese Preventive Medicine
基金
国家科技重大专项基金资助项目(2015ZX10001001-002)。
关键词
人类免疫缺陷病毒
基因亚型
耐药分析
Human immunodeficiency virus
Gene subtype
Drug resistance analysis
