温州地区未治疗AIDS病人的HIV毒株耐药基因变异研究

Research of HIV-1 drug resistance mutation among antiretroviral treatment naive individuals in Wenzhou

目的对温州地区未治疗艾滋病(AIDS)病人体内艾滋病病毒(HIV)毒株耐药基因的突变情况进行调查分析,了解该地区AIDS病人的本底耐药情况。方法对50例未接受抗病毒治疗的AIDS病人HIVpol区的蛋白酶(PR)全长和部分反转录酶(RT)基因进行扩增、脱氧核糖核酸(DNA)测序、亚型鉴定,并与国际HIV耐药数据库比对分析。结果共获得38份有效序列,根据pol区亚型分析发现,CRF01_AE占36.8%(14例),CRF07_BC重组占36.8%(14例),C亚型占18.4%(7例),B亚型占7.89%(3例)。未检出针对蛋白酶抑制剂(PIs)、核苷类反转录酶抑制剂(NRTIs)的耐药病例。针对非核苷类反转录酶抑制剂(NNRTIs)检出3例耐药病例,突变类型分别为V179D、E138A和K103N。同时,2015年温州HIV耐药毒株的传播水平<5%,处于低传播水平。结论对于未经抗病毒治疗组,耐药基因型以CRF01_AE重组、BC重组为主,HIV耐药毒株在温州仍处于低度传播水平,发现一个重要耐药基因突变位点是K103N。

Objective To investigate and analyze the mutation spectrum of HIV strains＇ resistant gene and to obtain the background information of HIV drug resistance before antiretroviral treatment of HIV infected people in Wenzhou.Methods 50 AIDS patients before antiretroviral treatment were recruited,to amplify their whole protease（PR）and part of reverse transcriptase（RT）gene by using RT-PCR.The results were compared with those of international HIV drug resistance database.Results Out of 50 cases,there were 38 cases whose fragments were effectively obtained,in which there were 14 cases of CRF01_AE（36.8%）,14 of CRF07_BC（36.8%）,7of subtype C（18.4%）,and 3of subtype B（7.89%）.Among all the 38 cases,no drug-resistant HIV-1 variants were detected either in protease inhibitors（PIs）or in nucleotide reverse transcriptase inhibitors（NRTIs）,except for 3cases in nonnucleotide reverse transcriptase inhibitors（NNRTIs）with the mutations of V179 D,E138Aand K103 Nfor each.Meanwhile,according to the guideline of HIV drug-resistant threshold survey（HIV DRTS）provided by the World Health Organization,we found that HIV drug-resistant strains were at a low level of transmission in 2015.Conclusion The antiviral treatment na6 ve individuals in Wenzhou have HIV resistant gene circulating recombinant forms（CRFs）of CRF01_AE,and BC,and the HIV resistant strains spread at a low level.The significant resistance gene mutation is K103 N.