2016-2017年山西省太原市艾滋病病毒感染者毒株基因特征及耐药分析

Genetic characteristics and drug resistance of HIV strains isolated in Taiyuan, Shanxi, 2016–2017

目的了解山西省太原市2016-2017年新报告未经治疗艾滋病病毒(HIV)感染者毒株亚型分布以及耐药毒株的传播。方法对太原市2016年8月至2017年12月新报告未经治疗的HIV/艾滋病患者(AIDS)进行调查。采集血样,提取RNA,获得pol区序列,构建系统进化树判定亚型。应用美国斯坦福大学HIVdb Program库进行耐药解读,并运用HyPhy 2.2.4软件和Cytoscape 3.6.1软件进行HIV-1分子网络分析。结果从调查的251名新报告未经治疗HIV/AIDS中获得227条pol区序列。发现太原市HIV-1毒株以CRF01AE亚型为主,占52.0%(118/227),其次为CRF07BC亚型占32.6%(74/227);2016-2017年新报告未经治疗HIV/AIDS中HIV-1耐药率为5.3%(12/227),针对非核苷类反转录酶抑制剂(NNRTI)耐药率为5.3%(12/227),针对核苷类反转录酶抑制剂(NRTI)耐药率为1.3%(3/227),未发现有蛋白酶抑制剂(PI)的耐药;按1.5%基因距离阈值构建分子网络入网率为40.1%(91/227),发现12个分子簇;亚型为CRF790107(P=0.01)的感染者入网率较高。结论太原市HIV-1流行毒株CRF01AE和CRF07BC两种亚型合计超过80%,针对NNRTI耐药率已超过5%;感染新型重组亚型CRF790107的感染者已形成簇传播,需加强该人群的调查和干预。

Objective To understand the distribution of virus subtypes and the spread of drug-resistance of HIV isolated from untreated people living with HIV/AIDS(PLWHA) in Taiyuan, Shanxi province during 2016–2017. Methods A survey was conducted in newly reported and untreated PLWHA in Taiyuan from August 2016 to December 2017. Blood samples were taken from them for the extraction of HIV nucleic acid RNA, the pol region sequences were obtained, and a phylogenetic tree was constructed for HIV subtype determination. Drug resistance was analyzed by using the Stanford University HIVdb Program library, and HIV-1 molecular network analysis was performed with software HyPhy 2.2.4 and software Cytoscape3.6.1. Results A total of 227 pol region sequences were obtained from 251 newly reported and untreated PLWHA in Taiyuan. The study found that HIV-1 strains isolated in Taiyuan were predominated by subtype CRF01AE, accounting for52.0%(118/227), followed by CRF07BC(32.6%, 74/227). The drug resistance rate of HIV-1 in the newly reported and untreated PLWHA was 5.3%(12/227), the resistance rate to non-nucleoside reverse transcriptase inhibitor(NNRTI) was 5.3%(12/227), and the resistance rate to nucleoside reverse transcriptase inhibitor(NRTI) was 1.3%(3/227), no protease inhibitor(PI) resistance was found. The molecular network access rate was 40.1%(91/227) according to the 1.5% gene distance threshold, and 12 clusters were found. The molecular network access rate was high in PLWHA infected with subtype CRF790107(P=0.01). Conclusion More than 80% of HIV-1 strains detected in Taiyuan belonged to subtype CRF01AE and CRF07BC, and the drug resistance rate to NNRTI was over 5%. The clustering transmission of infection of CRF790107 has been formed, so the investigation and intervention of this population need to be strengthened.