广西柳州16～25岁HIV-1感染者中流行毒株亚型及耐药分析

Distribution of HIV-1 subtypes and prevalence of transmitted drug resistance among HIV-1 infected people at 16-25 years of age in Liuzhou of Guangxi

目的通过对广西壮族自治区柳州市,2011-2013年艾滋病病毒Ⅰ型（HIV-1）新近感染者毒株基因特征的研究,了解当地HIV毒株流行及耐药毒株发生传播的情况。方法采集当年新确证的、16~25岁未接受抗病毒治疗的HIV-1感染者的血浆样本,共176份。提取病毒核糖核酸（RNA）,通过扩增HIV-1 pol区片段,进行测序和耐药基因变异分析。结果 3年共获得pol区序列176条,主要以CRF01_AE为主（86.9%,153/176）;其次也发现了少量CRF07_BC、CRF08_BC和B亚型。共有5例（2.8%,5/176）出现耐药突变,4例为异性性传播,1例为注射吸毒传播,其中1例针对蛋白酶类抑制剂（PI）,3例针对非核苷类抑制剂（NNRTIs）,另有2例针对核苷类抑制剂（NRTIs）发生耐药突变。结论当地主要流行毒株为CRF01_AE,广西柳州HIV-1新近感染者耐药传播目前处于低度传播水平,但仍要进一步加强对新近感染者的耐药监测和病人的治疗管理。

Objective To investigate genetic varieties and transmitted drug resistance of HIV strains in Guangxi in three consecutive years.Method Plasma samples were collected from newly diagnosed with HIV-1infected patients at the age of 16 to 25during 2010-2013.From these samples,viral genome was extracted,then HIV-1pol gene was amplified and sequenced.Based on pol sequences,HIV-1subtypes were determined by phylogenetic analyses,and drug resistance variants were identified.Result Totally 176 HIV-1pol sequences were obtained.Among these samples,5were found to harbor drug resistance strains,2were resistant to nucleoside reverse transcriptase inhibitors（NRTIs）,3were resistant to non-nucleoside reverse transcriptase inhibitors（NNRTIs）,or 1was resistant to protease inhibitors（PIs）.Among these persons,four were infected through sexual contact and one was infected through intravenous drug use.Based on pol sequences,identified HIV genotypes included CRF01_AE（86.9%,153/176）,CRF07_BC（9.7%,17/176）,CRF08_BC（2.8%,5/176）and B（0.6%,1/176）.Conclusion The prevalence of drug resistant that newly diagnosed HIV-1strains was low in Liuzhou.Further surveys would be needed to assess the trend of transmitted drug resistance and to give some hints on antiretroviral therapy.