天津市HIV/AIDS病人未治疗人群pol基因多态性及耐药性分析

Study on pol gene polymorphism and drug resistance among antiretroviral treatment-nave patients in Tianjin

目的了解天津市艾滋病病毒(HIV)感染者/艾滋病(AIDS)病人(简称HIV/AIDS病人)未治疗人群中,耐药基因的变异情况,比较不同基因亚型之间pol基因多态性耐药突变的分布差异。方法收集2010年天津市HIV/AIDS病人未治疗人群的血液样本,提取样本DNA,用巢式聚合酶链式反应扩增病毒pol基因,并进行亚型及耐药基因型分析。结果在79例样品中,扩增并得到有效pol基因序列的共有51例,共发现3种基因亚型。其中CRF01_AE为主要亚型,占49.02%(25/51);其次是B亚型,占41.18%(21/51)。检出耐药者8例,占15.69%(8/51),分别为低度和潜在低度耐药。耐药相关突变位点为K103R、V106I、V106IV、E138G、V179E和V179DINV。不同HIV-1基因亚型中,pol基因蛋白酶区和反转录酶区的基因突变差异较大。结论天津市HIV/AIDS病人未治疗人群中,存在一定程度的耐药问题,应加强对HIV-1耐药情况的监测,及时调整防治策略。

Objective To investigate background knowledge of drug-resistant mutation among antiretrovirai treatmentnaive patients in Tianjin, and compare the pol gene polyrnorphism among different genetic subtypes of HIV-1. Methods Seventy nine blood samples of antiretroviral treatment-naive patients were collected randomly in 2010. Nested PCR method was used to amplify pol genes sequences of HIV-1 after DNA was extracted. The nucleotide sequence of amplification products was determined, and the genetic subtype was identified by comparative analysis. Results Pol gene fragments of HIV-1 were successfully amplified for 51 samples and 3 kinds of HIV1 subtypes and recombinant gene were found. CRF01 AE was major subtype, accounting for 49.02% （25/51） of all positives. B was the second one, accounting for 41.18% （21/51）. Eight individuals were drug resistant, and the rate of drug resistance was 15.67%（8/15）. They had potential low-level resistance and low-level resistance respectively. The genotypes were K103R, V106I, V106IV,E138G, V179E and V179DINV. The pol gene polymorphism was different in different gene subtypes. Conclusions HIV-1 viruses with initial drug-resistant mutations were spreading in antiretroviral treatment-naive patients in Tianjin. The surveillance of drug resistance and the control of local HIV transmission should be strengthened in the future.