河北省保定市HIV-1感染者毒株基因亚型和耐药研究

HIV-1 genetic characteristics and drug resistance in newly diagnosed population in Baoding city of Hebei Province

目的了解河北省保定地区2020年全部新诊断的HIV-1感染者中,HIV-1毒株基因型和耐药发生情况。方法使用自建的方法扩增HIV-1 pol区全长基因并测序,系统进化分析鉴定HIV-1亚型,将基因序列上传至美国斯坦福大学的HIV耐药数据库,分析耐药突变位点发生情况。结果共收集新诊断HIV-1感染者96例,获得pol区全长83条,研究人群中男性88例(91.7%),平均年龄为39岁,已婚者54例(56.3%),感染途径以性接触途径(95.8%,92/96)为主,其中同性性传播占75.0%(72/96);系统进化分析显示,HIV-1毒株亚型多样,以CRF01_AE(51.8%,43/83)、CRF07_BC(24.1%,20/83)和B亚型(10.8%,9/83)为主,近年来新鉴定的重组毒株占13.3%(11/83);耐药分析结果显示,治疗前耐药率为8.4%(7/83),其中蛋白酶抑制剂(PIs)、非核苷类逆转录酶抑制剂(NNRTIs)和整合酶抑制剂(INIs)的耐药率分别为3.6%(3/83)、1.2%(1/83)和3.6%(3/83)。结论河北省保定地区2020年新诊断HIV-1感染者中毒株亚型复杂多样,存在多种独特重组毒株和耐药突变毒株,需要加强耐药监测和防控。

Objective To investigate the distribution of HIV-1 genotypes and drug resistance in newly diagnosed HIV-1 patients in Baoding in 2020.Methods A self-developed method was used to amplify the pol gene sequence of HIV-1,and the sequencing results were analyzed by phylogenetic analysis and compared with the Stanford drug resistance database to determine the HIV-1 subtypes and gene mutations.Results A total of 96 patients with HIV-1 infection were recruited in this study,and 83 pol gene sequences were successfully obtained.In the study population,88(91.7%)were male with an average age of 39 years and 54(56.3%)were married.Most of the patients were infected through sexual contact(95.8%,92/96),and 75.0%(72/96)were through homosexual transmission.Phylogenetic analysis showed that various HIV-1 subtypes were detected and among them,CRF01_AE(51.8%,43/83),CRF07_BC(24.1%,20/83)and B subtype(10.8%,9/83)were the most epidemic strains.Moreover,the subtypes of newly identified recombinant strains in recent years accounted for 13.3%(11/83).Drug resistance test results showed that the pre-treatment drug resistance rate in newly diagnosed HIV-1 patients was 8.4%(7/83),and the drug resistance rates to protease inhibitor(PIs),non-nucleoside reverse transcriptase inhibitors(NNRTIs)and integrase inhibitors(INIs)were 3.6%(3/83),1.2%(1/83)and 3.6%(3/83),respectively.Conclusions The HIV-1 subtypes in the newly diagnosed population in Baoding in 2020 were complex and diverse.There were many unique recombinant strains and drug-resistant strains.Therefore,it was necessary to strengthen drug resistance monitoring as well as the prevention and control of HIV-1 infection in this area.