2014年-2016年吉林省HIV-1耐药警戒线调查

Survey of HIV-1 drug resistance threshold in Jilin from 2014 to 2016

目的调查2014年-2016年吉林省HIV-1耐药株传播情况并分析耐药株传播水平的发展趋势。方法采用截断序贯抽样法,每年收集新确证HIV-1感染者且年龄在16岁~25岁,符合未进行抗病毒治疗条件的血浆样本各77例、50例和50例,提取RNA,采用RT-PCR方法扩增pol区,序列测定,对原发耐药基因变异进行分析。结果 2014年耐药传播率为2.67%(2/75);2015年未发生耐药传播,2016年耐药传播率为8.2%(4/49)。研究中的耐药株均为经性传播人群。3年的调查对象获得序列的样本中,亚型以CRF01_AE为主,分别占77.3%、68.1%和73.5%,且同性性传播为该亚型的主要来源,分别占96.0%、93.6%和100.0%。结论 2014年-2016年吉林省HIV-1耐药株的传播水平已经由低度发展到中度传播水平,HIV-1耐药传播流行株主要来自于同性性传播,且以CRF01_AE亚型为主,应对该人群开展连续的耐药传播情况监测,对男男性行为做好预防、教育和管理工作,切实做到控制耐药株的传播。

Objective To investigate the prevalence of the transmitted HIV-1 drug resistance（ TDR） and analyze the development trend within three successive years. Methods Plasma samples from newly detected HIV-1 cases aged from 16 to 25 were collected by binomial sequential sampling from which 77,50,50 treatment-naive HIV-1 cases were selected in each year. Then,viral RNA was extracted from plasma and the region of pol genes were amplified and sequenced,and gene mutation of primary drug resistance was analyzed. Results The prevalence of transmitted HIV-1 drug resistance was 2. 67%（ 2/75） in2014,there was no transmitted HIV-1 drug resistance case in 2015,the prevalence of transmitted HIV-1 drug resistance surged to 8. 2%（ 4/49） in 2016. All drug resistant strains were isolated from the patients who were infected through sexual transmitted. The main subtype from the accepted sequences was CRF01_ AE,accounting for 77. 3%,68. 1% and 73. 5%respectively; and the subtype was mainly from men who have sex with men,accounting for 96. 0%,93. 6% and 100. 0%.Conclusion The prevalence of the transmitted HIV-1 drug resistance was gradually transformed from low-level to mid-level in the three years. The HIV-1 drug resistant strains were mainly from homosexual transmission and in the main subtype was CRF01_AE. Successive surveillance of transmitted drug resistance should be carried out among treatment-naive groups,and measures should be taken on prevention,education and management among men who have sex with men,so as to control the transmission of HIV-1 drug resistant strains.