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2017-2019年广西钦州市部分新报告HIV/AIDS感染者病毒亚型及细胞嗜性研究

HIV subtypes and cellular tropism of newly reported infections in Qinzhou,Guangxi,2017-2019
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摘要 目的了解2017-2019年广西壮族自治区(广西)钦州市新报告人类免疫缺陷病毒(HIV)感染者/艾滋病患者(AIDS)中病毒基因亚型、耐药及细胞嗜性情况。方法选取2017-2019年钦州市部分新报告HIV/AIDS,检测CD4^(+)T淋巴细胞数量,并对HIV的pol、env基因区进行扩增、测序,构建系统进化树判定基因亚型。利用斯坦福耐药数据库判定新报告感染者的耐药情况,利用Geno2pheno判定嗜性,并采用非参数Wilcoxon或Kruskal-Wallis检验分析不同亚型、不同嗜性之间CD4^(+)T淋巴细胞数量的差异。结果764例新报告感染者中,CRF01_AE、CRF08_BC、CRF07_BC分别占比50.1%(383/764)、31.2%(238/764)、10.9%(83/764)。CRF01_AE中第1簇(Cluster1)、第2簇(Cluster2)分别占18.3%(70/383)、72.3%(277/383)。48例新报告感染者发生治疗前耐药,耐药率为6.3%;CD4^(+)T淋巴细胞数量<200个/μL的占51.4%;CRF01_AE、CRF08_BC与CRF07_BC 3种基因型之间CD4^(+)T淋巴细胞中位数M(P_(25),P_(75))分别为205(41,303)、238(105,336)、308(179,394)且计数水平不全相等(P<0.0001);辅助受体利用预测有108例为CXCR4(X4),656例为CCR5(R5);X4嗜性的CD4^(+)T淋巴细胞数量显著低于R5嗜性的CD4^(+)T淋巴细胞数量。结论2017-2019年钦州市新报告HIV/AIDS中存在多种病毒亚型,耐药水平较高,病毒嗜性预测分析将有助于采取针对性的防治措施。 Objective To understand the HIV genotypes,drug resistance and cell tropism in newly reported HIV infection cases in Qinzhou of Guangxi from 2017 to 2019.Methods Newly reported HIV infection cases reported in Qinzhou from 2017 to 2019 were selected.The number of CD4^(+)T lymphocytes in blood samples collected from the cases were detected.The pol and env gene regions of HIV virus were amplified and sequenced.Phylogenetic trees were constructed to determine gene subtypes.The Stanford Drug Resistance Database was used to determine drug resistance.Geno2pheno was used to determine tropism.The difference in number of CD4^(+)T lymphocytes among the cases infected with the viruses of different subtypes and different tropisms were analyzed.Results Among the 764 newly reported HIV infection cases,the cases infected with the viruses of subtype CRF01_AE,CRF08_BC,and CRF07_BC accounted for 50.1%(383/764),31.2%(238/764),and 10.9%(83/764).The cases with first cluster(Cluster1)and the second cluster(Cluster2)in the cases infected with HIV of CRF01_AE accounted for 18.3%(70/383)and 72.3%(277/383).In the newly reported HIV infection cases,48 had drug resistance before treatment,the drug resistance rate was 6.3%.The cases with CD4^(+)T lymphocytes less than 200 accounted for 51.4%.The median M(P_(25),P_(75))of CD4^(+)T lymphocytes in the cases infected with the viruses of subtype CRF01_AE,CRF08_BC and CRF07_BC were 205(41,303),238(105,336),308(179,394),and the levels were not all equal(P<0.0001).Coreceptor utilization prediction indicated that 108 cases were CXCR4 and 656 cases were CCR5.The number of CD4^(+)T lymphocytes in the cases with X4 tropism was significantly lower than that in the cases with R5 tropism.Conclusion There were multiple virus subtypes in newly reported HIV infection cases in Qinzhou from 2017 to 2019,and the level of drug resistance before treatment was high.The predictive analysis of virus tropism will facilitate the targeted prevention and treatment of HIV infection.
作者 沈建洋 曹志强 陈欢欢 沈智勇 王卫军 林兆森 黄荣叶 李梅 陈锦妹 赵慧华 蒋丽萍 吴福宝 冯毅 阮玉华 邢辉 廖玲洁 李剑军 Shen Jianyang;Cao Zhiqiang;Chen Huanhuan;Shen Zhiyong;Wang Weijun;Lin Zhaosen;Huang Rongye;Li Mei;Chen Jinmei;Zhao Huihua;Jiang Liping;Wu Fubao;Feng Yi;Ruan Yuhua;Xing Hui;Liao Lingjie;Li Jianjun(National Center for AIDS/STD Control and Prevention,Chinese Center for Disease Control and Prevention,Beijing 102206,China;Guangxi Zhuang Autonomous Region Center for Disease Control and Prevention,Nanning,Guangxi 530028,China.;Qinzhou City Center for Disease Control and Prevention,Qinzhou,Guangxi 535000,China;Lingshan County Center for Disease Control and Prevention,Lingshan,Guangxi 535400,China;Pubei County Center for Disease Control and Prevention,Pubei,Guangxi 535300,China;Qinnan District Center for Disease Control and Prevention,Qinzhou,Guangxi 535000,China;Qinbei District Center for Disease Control and Prevention,Qinzhou,Guangxi 535000,China)
出处 《疾病监测》 CAS CSCD 北大核心 2021年第5期445-451,共7页 Disease Surveillance
基金 国家科技重大专项(No.2018ZX10721102-006) 广西自然科学基金(No.2020GXNSFAA159020) 广西八桂学者艾滋病防控关键技术岗位专项 广西艾滋病防控与成果转化研究重点实验室。
关键词 人类免疫缺陷病毒 亚型 耐药 嗜性 Human immunodeficiency virus Subtypes Drug resistance Tropism
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