浙江省台州地区新确诊HIV感染者耐药突变研究

HIV drug resistance among newly-diagnosed HIV-infected patients in Taizhou prefecture of Zhejiang Province

目的了解浙江省台州地区新确诊艾滋病病毒(human immunodeficiency virus,HIV)感染者HIV原发性耐药情况。方法对浙江省台州地区2012-2013年新确诊的所有≥18岁的HIV感染者进行pol基因扩增并测序。运用美国阿拉莫斯国家实验室HIV核酸序列库,判定HIV基因亚型。根据WHO耐药突变位点列表(2009年)并参照美国斯坦福大学HIV耐药数据库,确定HIV耐药突变位点及其对各种抗逆转录病毒药物的敏感性。结果共有507名HIV感染者纳入研究,成功扩增416例(82.1%)患者血浆HIV的pol基因,共发现7种HIV基因亚型,分别是CRF01_AE、CRF07_BC、CRF08_BC、B、CRF01_AE/B、CRF01_BC和CRF06_cpx,以CRF01_AE为最具优势的亚型,占49.8%;其次是CRF07_BC,占32.0%。13例感染者具有WHO推荐的耐药突变位点,耐药率为3.1%。结论浙江省台州地区的HIV原发性耐药率处于低水平状态,然而,潜在耐药突变率较高,随着扩大抗病毒治疗的进一步推动,有必要加强HIV耐药监测。

Objective To investigate HIV drug resistance （HIVDR） among newly-diagnosed HIV infected indi- viduals in Taizhou prefecture, Zhejiang province. Methods During 2012 -2013, all newly-diagnosed HIV-infected adults in Taizhou prefecture were examined for HIVDR by amplifying and sequencing HIV-1 pol gene. HIV-1 subtype reference sequences available at the Los Alamos HIV Sequences Database were used for HIV-1 subtyping. HIVDR and viral suscepti- bility to ARTs were interpreted with the Surveillance Drug Resistance Mutations （SDRM） list recommended by WHO. Re- suits Out of the 507 newly-diagnosed HIV-infected adults, 416（82. 1% ） were successfully genotyped. Multiple subtypes were identified, including CRFOI_AE, CRF07_BC, CRF08_BC, B, CRFOI_AE/B, CRF01 BC and CRF06_epx. The pre- dominant HIV-1 subtype was CRF01_AE （49. 8% ）, followed by CRF07_BC （32. 0% ）. Thirteen participants （3.1%） met the WHO guidelines of having HIVDR. Conclusions The prevalence of HIVDR among newly-diagnosed HIV-infected indi- viduals is low in the studied area. However, given high frequency of minor HIVDR among HIV carriers and the scaling up of ART in China, improved HIVDR surveillance programmes are needed.