新疆乌鲁木齐市2014年HIV-1耐药毒株传播分析

Survey on transmitted HIV-1 drug resistance in Urumqi,Xinjiang in 2014

目的 调查乌鲁木齐市2014年艾滋病病毒1型（HIV-1）耐药毒株的传播情况。方法 参考世界卫生组织（WHO）的艾滋病传播性耐药调查方法,按确证时间顺序采集当年16～25岁新确证HIV-1感染者全血样本33份,分离血浆,提取病毒基因组RNA,扩增包含完整蛋白酶编码区和反转录酶1～250氨基酸基因区的pol基因片段并测序,利用Mega 6.0软件,通过与参考株pol序列构建进化树确定HIV-1亚型,pol序列与Stanford耐药数据库中的共享序列进行比对,利用WHO提供的CPR 5.0软件分析传播性耐药突变位点和耐药程度。结果 检测的33份样本中成功获得序列的有32份,亚型以CRF07-BC（50.0%,16/32）为主,其次是CRF01-AE（34.4%,11/32）。32份样本中只有1份出现了耐药传播相关的突变位点,耐药传播率为3.1%（1/32）。结论乌鲁木齐市2014年的耐药传播水平较低,但应继续定期进行HIV-1耐药毒株传播的监测,了解HIV-1耐药毒株传播的动态变化。

Objective To evaluate the level of transmitted human immunodeficiency virus （HIV） drug resistance in Urumqi in 2014. Methods Following the WHO protocols for surveillance of transmitted HIV drug resistance （HIVDR）, blood specimens were consecutively collected from 33 newly diagnosed HIV-1 infected individuals be- tween 16 and 25 years old. Plasma was separated from the whole blood. Then viral RNA was extracted from plasma specimens. A Pol fragment containing the whole protease open reading frame and 1 to 250 amino acid of reverse transcriptase gene was amplified and sequenced. HIV-1 subtypes were determined by constructing phylogenetic trees with the obtained and reference pol sequences using Mega 6.0. The pol sequences were aligned and compared with the consensus pol sequence in Stanford HIVdb. The transmitted drug resistance mutations were identified using CPR 5.0 provided by WHO, and the levels of drug resistance was determined accordingly. Results 32 specimens were successfully amplified and sequenced. Among them, 50.0 % （16/32） were CRF07_BC, follow by CRF01_AE （34.4%, 11/32）. Only one of the 32 genotyped specimens were identified to have a mutation associated with drug resistance （K103N） in the reverse transcriptase gene, which could lead to a high level of drug resistances to both EFV and NVP. Conclusion The prevalence of transmitted HIVDR is relatively low in Urumqi. To provide more solid data for the prevention and care of HIV/AIDS, surveillance of transmitted HIVDR should be periodically per-formed,