摘要
目的了解杭州市新报告HIV感染者/艾滋病患者(HIV/AIDS)抗逆转录病毒治疗(ART)前HIV-1亚型流行特征及耐药情况。方法收集杭州市2020—2022年新确证且未经抗病毒治疗的HIV/AIDS病例血样,扩增HIV-1 pol区基因并测序。使用MEGA7.0软件构建系统进化树判断亚型,提交序列至斯坦福大学耐药数据库,确定耐药突变位点及毒株对药物的敏感性。结果获得2700条pol基因序列,发现12种HIV-1亚型,以CRF07_BC(46.8%,1263/2700)和CRF01_AE(34.6%,933/2700)为主。ART前HIV-1耐药率8.1%(220/2700),其中,蛋白酶抑制剂(PIs)、核苷类反转录酶抑制剂(NRTIs)和非核苷类反转录酶抑制剂(NNRTIs)耐药率分别为2.8%(75/2700)、1.3%(36/2700)和4.4%(119/2700)。220例耐药病例中,PIs耐药突变位点为Q58E(21.4%,47/220),NRTIs耐药突变位点为M184V/I(5.9%,13/220),NNRTIs耐药突变位点为K103N/S(19.1%,42/220)和E138A/G/K/Q(18.6%,41/220)。结论2020—2022年杭州市新报告HIV/AIDS病例中HIV-1基因型高度复杂,ART前耐药达到中度流行水平,发现对骨干药物中度及高度耐药病例,应加强监测,避免治疗失败并减少耐药株的传播。
Objective To analyze the HIV-1 subtypes and drug resistance among newly reported HIV/AIDS cases before antiretroviral therapy(ART)in Hangzhou.Methods Blood samples were collected from newly diagnosed HIV-1/AIDS cases not receiving ART in Hangzhou from 2020 to 2022.HIV-1 pol gene was amplified and then sequenced.A phylogenetic tree was construct using MEGA7.0 software to analyse the HIV-1 subtypes,The sequences were submitted to the Stanford University drug resistance database to identify drug resistance mutation sites and drug sensitivity.Results A total of 2700 sequences were obtained.Twelve subtypes were identified,and the predominant subtypes were CRF07_BC(46.8%,1263/2700)and CRF01_AE(34.6%,933/2700).The overall drug resistance rate before ART was 8.1%(220/2700)and the resistance rates to protease inhibitors(PIs),nucleoside reverse transcriptase inhibitors(NRTIs)and non-nucleoside reverse transcriptase inhibitors(NNRTIs)were 2.8%(75/2700),1.3%(36/2700)and 4.4%(119/2700),respectively.Among the 220 drug-resistant cases,mutations conferring resistance to PIs(Q58E),NRTIs(M184V/I)and NNRTIs(K103N/S and E138A/G/K/Q)were detected in 47(21.4%),13(5.9%),42(19.1%)and 41(18.6%)patients,respectively.Conclusions HIV-1 genotypes were highly complex in newly reported HIV/AIDS cases in Hangzhou from 2020 to 2022.There were cases showing moderate or high resistance to backbone drugs before ART,indicating that HIV-1 monitoring should be strengthened to avoid treatment failure and reduce the spread of drug-resistant strains.
作者
叶灵
许珂
张兴亮
罗文杰
尤佳女
吴嗣圣
朱敏
Ye Ling;Xu Ke;Zhang Xingliang;Luo Wenjie;You Jia′nyu;Wu Sisheng;Zhu Min(Institute for AIDS/STD Prevention and Treatment,Hangzhou Center for Disease Control and Prevention,Hangzhou 310002,China)
出处
《中华微生物学和免疫学杂志》
CAS
CSCD
北大核心
2023年第7期541-546,共6页
Chinese Journal of Microbiology and Immunology
基金
杭州市农业与社会发展科研一般项目(20201203B203)
杭州市农业与社会发展科研引导项目(20220919Y062)
杭州市医学重点学科(感染性疾病学)。
关键词
HIV-1
亚型
治疗前耐药
HIV-1
Subtype
Pretreatment drug resistance
