2013年江西省HIV-1耐药警戒线调查

Drug resistance threshold survey of HIV-1 in Jiangxi province in 2013

目的了解2013年江西省HIV-1耐药株的传播水平。方法采用WHO的二项顺序抽样法,随机抽取2013年江西省16岁-25岁符合耐药警戒线调查标准的HIV-1感染者血浆样本,提取病毒RNA,采用RT-PCR和巢式PCR扩增HIV pol区基因片段进行原发耐药基因变异分析。结果 47个研究对象的HIV亚型有CRF07_BC、CRF01_AE和B＇亚型,分别占51.06%（24/47）、42.55%（20/47）和6.38%（3/47）,其中CRF07_BC和CRF01_AE为主要亚型;不同传播途径的感染者中,HIV亚型分布差异无统计学意义。47份样本中仅有1份来自异性性接触感染者的样本存在RT区耐药突变位点（M184V）。结论 2013年江西省HIV-1耐药株的传播水平为低度（〈5%）,个体在抗病毒治疗前尚不需要进行耐药检测。但是随着抗病毒治疗规模的逐步扩大,有必要继续加强HIV耐药株传播的监测工作。

Objective To survey the prevalence of HIV- 1 drug resistance in Jiangxi province in 2013. Methods Plasma samples were collected from people infected HIV- 1 who were aged from 16 to 25 years old and randomly selected by binomial sequential sampling. Then,extracted RNA from plasma and the region of pol genes were amplied by RT- PCR and nested PCR. Antiretroviral- resistant mutations were determined for analysis by sequencing the region of pol genes. Results The predominant subtypes of 47 objects of study were CRF07_ BC,CRF01_ AE and B＇,the percentage of them were respectively51. 06%（ 24 /27）,42. 55%（ 20 /47） and 6. 38%（ 3 /47）. CRF07_BC and CRF01_AE were major; Among infected objects with different infection ways,the distribution differences of HIV subtypes were no statistically significant. And only one heterosexual infection case was found out of the 47 cases,and drug resistance mutation site（ M184V） was found in the RT region of its sample. Conclusion The prevalence of HIV- 1 drug resistance in Jiangxi province was estimated as low（ 〈5%）. It＇ s no need to test drug resistance before starting antiretroviral therapy for HIV infections or AIDS. However,with the continued scale of ART,the monitoring of HIV drug resistant strains should be strengthened.