2022年吉林省HIV感染者抗病毒治疗前耐药监测结果分析

Pre-antiviral treatment drug resistance monitored in HIV-infected patients in Jilin Province,2022

目的了解吉林省HIV感染者抗病毒治疗前耐药情况,为艾滋病感染者持续抗病毒治疗提供数据支持。方法结合中国疾控中心性艾中心2022年抗病毒治疗前HIV耐药监测调查项目,共采集228例HIV感染者抗病毒治疗前血样,进行耐药检测,并调取全国艾滋病综合防治信息系统基本信息,分析当前吉林省HIV感染者抗病毒治疗前耐药情况。结果吉林省2022年HIV感染者抗病毒治疗前耐药率为9.2%(19/206),高于2018年的7.5%(11/146)。NNRTIs,NRTIs,PIs药物耐药率分别为8.3%,1.9%,0.0%,其中7.8%(16/206)的HIV感染者对EFV耐药,8.3%(17/206)的HIV感染者对NVP耐药。主要耐药突变位点为:NNRTIs类V179D/E(3.9%)、K103N(1.9%)、V106I/A/M(1.0%)、Y181C(1.0%)、K101E(1.0%)、Y188L(1.0%)、K238T(1.0%);NRTIs类M184V(0.5%)、A62V(0.5%)、K70E(0.5%)、L210WI(0.5%)。结论吉林省HIV感染者治疗前耐药目前处于WHO定义的中度流行水平。吉林省2022年HIV感染者抗病毒治疗前耐药株出现的主要耐药位点以NNRTIs为主,耐药相关突变位点以V179D/E为主。耐药突变类型与中国广泛使用的免费抗病毒治疗药物种类相符。

Objective To understand the drug resistance of HIV-infected people before antiviral treatment in Jilin,provi-ding data support for continuous antiviral treatment of this group.Methods Combined with the pre-antiviral treatment HIV drug resistance monitoring and investigation project 2022 of the National Center for AIDS/STD Control and Prevention,Chi-na CDC,blood samples of 228 HIV-infected individuals in Jilin were collected for drug resistance monitoring before antivi-ral treatment.Then an analysis was performed on the monitoring results with the support of participants’personal informa-tion obtained from the National AIDS Comprehensive Control and Prevention Information System.Results In Jinlin in 2022,the pre-antiviral treatment drug resistance rate was 9.2%(19/206)in HIV-infected individuals,which was higher than that[7.5%(11/146)]of those monitored in 2018.The rates of resistance to non-nucleoside reverse transcriptase in-hibitors(NNRTIs),nucleoside reverse transcriptase inhibitors(NRTIs)and protease inhibitors(PIs)were 8.3%,1.9%and 0.0%,respectively.Specifically,7.8%(16/206)of HIV-infected people were resistant to efavirenz(EFV)and 8.3%(17/206)were resistant to nevirapine(NVP).The main mutation sites related to NNRTIs resistance were V179D/E(3.9%),K103N(1.9%),V106I/A/M(1.0%),Y181C(1.0%),K101E(1.0%),Y188L(1.0%),and K238T(1.0%),and those related to NRTIs resistance were M184V(0.5%),A62V(0.5%),K70E(0.5%),and L210WI(0.5%).Conclusion The pretreatment HIV drug resistance in Jilin is at the moderate epidemic level defined by WHO.In Jilin 2022,the strains of HIV were mainly resistant to NNRTIs before antiviral therapy,with V179D/E as the major resist-ance-associated mutation site.And the types of resistance-associated mutations were consistent with the types of free antivi-ral drugs widely used in China.