2015年福州市HIV-1分子流行病学分析

Analysis on molecular epidemiology of HIV-1,Fuzhou city,2015

目的了解福州市2015年新发HIV感染者/AIDS病例艾滋病病毒感染毒株的亚型流行特征及原发性耐药情况,为有效开展艾滋病监测和防控提供科学依据。方法 2016年采集2015年新发HIV感染者/AIDS病例的340份HIV阳性血样,送福建省疾病预防控制中心提取HIV核酸,通过PCR技术扩增HIV-1基因的env、gag、pol区域,将PCR产物测序后进行分析,确定其基因亚型;采用美国斯坦福大学HIV国际耐药数据库进行耐药分析。结果 340份样本中,241份基因扩增阳性,发现9种HIV-1亚型和重组亚型。其中CRF07-BC重组型116份、CRF01-AE重组型80份、B亚型11份、CRF55-01B重组型10份、CRF08-BC重组型5份、CRF68-01B重组型5份、C亚型1份、CRF33-01B重组型1份、未知重组型12份。241份中,共发现31例耐药者,占12.86%;包括对蛋白酶抑制剂(PIs)耐药的5份(占2.07%),对核苷类反转录酶抑制剂(NRTIs)耐药的3份(占1.25%),对非核苷类反转录酶抑制剂(NNRTIs)耐药的23份(占9.54%)。241份HIV-1阳性标本的CD4+T淋巴细胞绝对值计数为2~1 094个/μl,平均322.49个/μl(P>0.05)。结论福州市存在多种HIV-1亚型流行,以CRF07-BC和CRF01-AE为主要亚型;耐药监测发现PIs、NRTIs、NNRTIs耐药突变株。

Objective To understand the epidemiological characteristics of HIV-1 subtype and status of primary drug re- sistance in HIV infected individuals diagnosed first in 2015 and living in Fuzhou city, so as to provide scientific basis for ef- fectively carrying out HIV survey and development of AIDS prevention and control strategy. Methods A total of 340 HIV-positive plasma samples were collected and sent to Fujian Provincial Centre for Disease Control and Prevention where HIV nucleic acid was extracted,the env,gag,pol gene fragments of HIV-1 were amplified with polymerase chain reaction （PCR）, the PCR products were sequenced and analyzed to identify subtype. The drug resistance of H/V-1 strains were ob- tained by comparing with Standford HIV drug resistance database. Results In a total of 340 samples,241 samples were successfully amplified, there were nine HIV-1 subtypes and restructuring subtypes. Including 116 CRF07-BC, 80 CRF01- AE, 11 subtype B, 10 CRF55-01B,5 CRF08-BC,5 CRF68-01B, 1 subtype C, 1 CRF33-01B and 12 unknown recombination forms. 31 cases of drug resistance were detected, accounting for 12.86%, including 5 resistance to PIs （2.07%）, 3 resist- ance to NRTIs（1.25%）, 23 resistance to NNRTIs （9.54%）. The 241 specimens, the mean value of CD4 ＋ T lymphocyte absolute number was 322.49/μl,the lowest one was 2/μl,the highest one was 1 094//11（ P 〉0.05）. Conclusion Multi- ple HIV-1 subtypes exist in Fuzhou, the CRF01-BC and CRF01-AE are predominant subtypes. The drug resistance mutant strains to PIs,NRTIs and NNRTIs are found in monitoring drug resistance.