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2021年上海市虹口区HIV-1基因亚型及耐药监测结果分析

Analysis on HIV-1 genotype distribution and drug resistance in Hongkou district,Shanghai,2021
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摘要 目的通过监测2021年上海市虹口区HIV-1基因亚型和耐药情况,为虹口区HIV-1耐药数据库的建立和艾滋病防治策略的及时调整提供数据支撑。方法收集2021年1—12月HIV-1感染者血浆样本,使用反转录–巢式PCR技术进行HIV1病毒Pol基因扩增,通过COMET工具和构建进化树鉴定基因亚型,并采用美国斯坦福大学HIV耐药数据库对其耐药情况进行分析。结果共获得143条Pol基因序列,10种基因亚型,其中CRF01_AE亚型49条(34.27%)、CRF07_BC亚型52条(36.36%)、C亚型13条(9.09%)、B亚型9条(6.29%)、CRF08_BC亚型9条(6.29%)、CRF55_01B亚型4条(2.80%)、CRF67_01B亚型2条(1.40%)、CRF68_01B亚型1条(0.70%)、A亚型1条(0.70%)和独特重组亚型(URFs)3条(2.10%)。研究发现,治疗前耐药率为10.49%(15/143),其中非核苷类反转录酶抑制剂治疗前耐药率为6.29%(9/143);核苷类反转录酶抑制剂治疗前耐药率为1.40%(2/143);蛋白酶抑制剂治疗前耐药率为2.80%(4/143);利匹韦林、奈韦拉平和依非韦伦治疗前耐药率分别为4.90%、3.50%和3.50%。此外,监测到传播耐药率为4.20%(6/143),传播耐药突变位点分别为M46I、M184V、K103N、K101E和Y181C,预测对依非韦伦、奈韦拉平、恩曲他滨和拉米夫定为高度耐药。结论HIV-1基因亚型的构成在虹口区已经愈发多样化,应继续加强辖区内HIV-1基因亚型以及耐药毒株的监测工作,特别是非核苷类逆转录酶抑制剂相关的治疗前耐药和传播耐药研究。 Objective To understand the genotypes and drug resistance of HIV-1 in Hongkou district of Shanghai in 2021,and provide data support for establishing HIV-1 drug resistance database and adjusting prevention and treatment strategies of acquired immune deficiency syndrome in time.Methods Plasma samples of HIV-1 positive patients were collected from January to December,2021,and the Pol gene of HIV-1 was amplified by reverse transcription-nested PCR.The genotypes of HIV-1 were identified by COMET tool and phylogenetic tree,and the drug resistance was analyzed by Stanford University HIV Drug Resistance Database.Results A total of 143 Pol sequences and 10 genotypes were obtained.The HIV-1 genotypes included CRF01_AE,CRF07_BC,C,B,CRF08_BC,CRF55_01B,CRF67_01B,CRF68_01B,A,and URFs,accounting for 34.27%,36.36%,9.09%,6.29%,6.29%,2.80%,1.40%,0.70%,0.70%,and 2.10%,respectively.It was found that the rate of pretreatment HIV drug resistance(PDR)was 10.49%(15/143).The PDR rate of non-nucleoside reverse transcriptase inhibitors was 6.29%(9/143).The PDR rate of nucleoside reverse transcriptase inhibitors was 1.40%(2/143).The PDR rate of protease inhibitors(PIs)was 2.80%(4/143).The PDR rate of rilpivirine,nevirapine and efavirenz were 4.90%,3.50%and 3.50%,respectively.In addition,the rate of transmitted HIV drug resistance(TDR)was 4.20%(6/143),and the TDR mutations were detected at M46I,M184V,K103N,K101E and Y181C,which were predicted to be highly resistant to efavirenz,nevirapine,emtricitabine and lamivudine.Conclusion The genotypes of HIV-1 in Hongkou are becoming increasingly diverse.Therefore,surveillance for HIV-1 genotypes and drug-resistant strains,especially the PDR and TDR associated with non-nucleoside reverse transcriptase inhibitors,should be further strengthened.
作者 贾敏 李佳洁 洪亮 陶静 Jia Min;Li Jiajie;Hong Liang;Tao Jing(Hongkou District Center for Disease Control and Prevention,Shanghai 200082,China)
出处 《疾病监测》 CAS CSCD 北大核心 2024年第7期869-874,共6页 Disease Surveillance
基金 2021年上海市疾病预防控制中心创新特色项目(No.SCDC-2021-08)。
关键词 HIV-1 基因亚型 治疗前耐药 传播耐药 HIV-1 Genotype Pretreatment drug resistance Transmission drug resistance
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