2004-2022年我国HIV-1 CRF08_BC亚型感染者抗病毒治疗前耐药分析

Analysis on pre-antiretroviral treatment drug resistance in people infected with HIV-1CRF08_BC in China,2004−2022

目的了解我国HIV-1 CRF08_BC未抗病毒治疗感染者对蛋白酶类抑制剂(PIs)、核苷类反转录酶抑制剂(NRTIs)、非核苷类反转录酶抑制剂(NNRTIs)的耐药情况。方法收集2004—2022年全国耐药调查以及Los Alamos HIV基因数据库中未治疗感染者的CRF08_BC亚型序列,利用美国斯坦福大学Los Alamos HIV基因数据库进行耐药判定,采用HIV-TRACE软件进行HIV-1耐药传播网络分析。结果收集HIV-1 CRF08_BC序列4539条,总耐药率为15.27%(693/4539)。PIs、NRTIs和NNRTIs的耐药率分别为1.70%(77/4539)、1.85%(84/4539)、12.91%(586/4539);其中利匹韦林(RPV)的耐药率最高,为11.28%(512/4539)。多重耐药率为0.1%(44/4539)。结论近年来我国CRF08_BC感染者耐药率不断升高,主要由NNRTIs药物耐药率逐年上升引起,其中RPV的耐药率最高,且存在耐药毒株的传播,治疗前耐药对我国抗病毒治疗效果的影响还需进一步监测和分析。

Objective To investigate the pre-antiretroviral treatment resistance to protease inhibitors(PIs),nucleoside reverse transcriptase inhibitors(NRTIs),and non-nucleoside reverse transcriptase inhibitors(NNRTIs)in people infected with HIV-1 CRF08_BC in China.Methods From national HIV drug resistance survey database and HIV database of China and Los Alamos HIV gene database,HIV-1 CRF08_BC sequences were selected in pre-antiretroviral treatment samples collected between 2004 and 2022.Drug resistance was analyzed by using Stanford HIVdb Program.Molecular transmission networks were constructed by using software HIV-TRACE.Results A total of 4539 HIV-1 CRF08_BC sequences were included,and the overall drug resistance rate was 15.27%(693/4539).The resistance rates to PIs,NRTIs and NNRTIs were 1.70%(77/4539),1.85%(84/4539),and 12.91%(586/4539),respectively.In which the resistance rate to rilpivirine was highest(11.28%,512/4539).The rate of multi-drug resistance was 0.1%(44/4539).Conclusion In recent years,the drug resistance rate in HIV-1 CRF08_BC-infected patients increased in China,which could be explained by increased resistance to NNRTIs,in which the resistance rate to rilpivirine was highest.The transmission of drug-resistant strains exists in China,indicating that preantiretroviral treatment drug resistance on antiretroviral therapy needs to be further monitored and analyzed.