深圳市龙岗区老年HIV/AIDS人群流行病学特征及原发性耐药分析

Epidemiological characteristics and primary drug resistance of elderly HIV/AIDS population in Longgang District of Shenzhen

目的了解深圳市龙岗区新增确证≥50岁老年艾滋病病毒感染者(HIV)/艾滋病病人(AIDS)的流行病学特征及耐药状况,为制定老年艾滋病防控策略提供参考数据。方法对龙岗区2016—2019年新报告≥50岁老年HIV/AIDS开展流行病学横断面研究,对随机选取的血清样本提取病毒RNA,采用巢式RT-PCR法扩增HIV-1 pol区基因片段并测序,以邻接法(Neighbor-Joining method,NJ)构建系统进化树确定基因亚型,并将测序结果上传至美国斯坦福大学HIV耐药数据库进行耐药分析。结果龙岗区2016—2019年新报告≥50岁HIV/AIDS数253例,2016—2018年各年≥50岁病例构成比分别为14.41%、17.34%、18.41,呈上升趋势。男性占比最高(77.47%,196/253),外省户籍居多(71.54%,181/253),传播途径以非婚异性传播为主(75.10%,190/253)。对扩增成功的48份pol基因序列分析共发现CRF01_AE、CRF07_BC、CRF55_01B、B及G 5种基因亚型,以CRF01_AE和CRF07_BC为优势亚型;4例感染者携带耐药突变位点,总耐药率为8.33%,8例感染者具有潜在耐药突变位点,。结论深圳市龙岗区新增确证老年HIV/AIDS患者的原发性耐药率处于中度流行水平,且潜在耐药突变较高,有必要加强HIV耐药监测。

Objective This study aims to realizethe epidemiological characteristics and prevalence of drug resistance among newly-diagnosed HIV infected/AIDS of elderly people aged≥50 years in Longgang District of Shenzhen,to provide reference data of AIDS prevention and control strategies for the elderly.Methods A cross-sectional study of epidemiology was carried out on newly reported HIV/AIDS infections among≥50-year-old population in Longgang District during 2016-2019.Plasma samples were selected by random sampling,and its RNA were extracted.The pol gene segments of HIV-1 genome from these RNA samples were amplified and sequenced by nested reverse transcription polymerase chain reaction(nested-RT-PCR).HIV subtype were determined through phylogenetic tree produced by Neighbor-Joining method.The sequence data were submitted to Stanford University HIV Drug Resistance Database for drug resistance analysis.Results From 2016 to 2019,253 HIV/AIDS cases≥50 years old were newly reported in Longgang district,and the proportion of cases≥50 years old in each year from 2016 to 2018 was 14.41%,17.34%and 18.41%,showing an increasing trend.Among them,the majority were males(77.47%,196/253)and migrants(71.54%,181/253),and were infected mainly through heterosexual behavior(75.10%,190/253).A total of 48 HIV-1 pol gene sequences were obtained and analyzed.Five HIVsubtypes of CRF01_AE,CRF07_BC,CRF55_01B,B,G were found,and which CRF01_AE,CRF07_BC were the predominant subtypes.Four cases with drug resistant mutations,and 8 cases with potential drug resistant mutations were found,and the prevalence of transmitted drug resistance was 8.33%.Conclusions The prevalence of drug resistance among newlydiagnosed HIV infected of elderly people aged≥50 years remained at intermediate level,and potential drug resistant mutations were high.It is necessary to strengthen drug resistance monitoring in new report HIV/AIDS infections among 50-year-old population.