摘要
分析宁夏地区HIV-1异性传播人群的基因亚型分布和耐药突变特征。收集2021年宁夏接受抗病毒治疗的HIV/AIDS患者的血浆样品并进行横断面调查,对病毒载量大于400拷贝/mL且感染途径为异性传播的患者进行基因型耐药检测,分析基因亚型及耐药特征。101例通过异性传播的HIV/AIDS患者中,共发现9种HIV-1亚型毒株流行,CRF07_BC亚型和CRF01_AE亚型为主要基因亚型。43例患者出现耐药基因突变,总体耐药率为2.10%(43/2 046),仍处于低流行水平,以NRTIs/NNRTIs为主,NNRTIs耐药突变率高于NRTIs和PIs。PI耐药突变位点主要为M46L和Q58E;NRTI耐药突变以M184V/I/MV、K65KR/R/N、K70E/KN为主;NNRTI耐药突变以K103N/KN/S、V179D/E/T、V106M/A/I为主。NRTIs耐药者对FTC和3TC高度耐药最多均为18.81%;NNRTIs耐药者对NVP和NEFV高度耐药最多,且耐药发生率最高均为35.64%;未发现PI高度耐药。2021年宁夏异性传播人群HIV-1基因亚型多样性增加,共检出9种HIV-1基因亚型,以CRF07_BC亚型和CRF01_AE亚型为主,且首次检出CRF59_01B亚型。该人群的总耐药率为2.10%,依据WHO提出的5%中度耐药警戒线,仍处于低流行水平。在耐药情况方面,以NNRTIs/NRTIs耐药为主,其中CRF01_AE亚型耐药率最高。提示需要持续关注HIV-1基因亚型的变化,加强监测HIV-1耐药毒株的流行情况,并扩大样本量持续探讨基因亚型和耐药之间的关联性,从而有效控制耐药的发生。
This study aims to analyze the distribution of HIV-1 genotypes and the characteristics of drug resistance mutations in heterosexual HIV-1 transmission population in Ningxia,China.Plasma samples were collected from HIV/AIDS patients receiving ART in Ningxia,China in 2021 and a cross-sectional survey was conducted.HIV-1 genotypic drug resistance testing was performed in patients who were infected by heterosexual transmission with viral load>400 copies/mL,and the characteristics of HIV genotypes and drug resistance were analyzed.Nine HIV-1 subtypes were circulated among 101 heterosexual HIV/AIDS patients,and the main gene subtypes were CRFO7.BC and CRFO1_AE.Forty-three patients had drug-resistant mutations,and the overall drug resistance rate was 2.10%,which was still at a low epidemic level,mainly with double resistance of NRTI/NNRTI.The resistant rate of NNRTI was higher than NRTI and PI.The main PI mutations were M46L and Q58E.NRTI mutations occurred mainly at M184V/1/MV,K65KR/R/N,K70E/KN.NNRTI mutations occurred mainly at K103N/KN/S,V179D/E/T,and V106M/A/I.Among the patients with NRTI resistance,18.81%were highly resistant to FTC and 3TC.NNRTI resistant patients were most highly resistant to NVP and EFV,and the highest incidence of drug resistance was 35.64%.There was no high drug resistance to PI.In 2021,the genetic diversity was increased in the heterosexual transmission population in Ningxia,China with a total of 9 HIV-1 gene subtypes detected,mainly CRFO7.BC and CRFO1_AE subtypes,and the CRF59_O1B subtype was detected for the first time.The total drug resistance rate of this population was 2.10%,which was still at the low epidemic level according to the moderate drug resistance warning line of 5%proposed by World Health Organization.In terms of drug resistance,NNRTIs/NRTIs was the main drug resistance,and CRFO1_AE subtype had the highest drug resistance rate.It is necessary to strengthen the monitoring of HIV-1 subtypes and the prevalence of drug-resistant strains,and to expand the sample size to continuousl
作者
司冰倩
马春花
吴玉灵
李宗倍
裴建新
杨东智
吴忠兰
张银豪
SI Bingqian;MA Chunhua;WU Yuling;LI Zongbei;PEI Jianxin;YANG Dongzhi;WU Zhonglan;ZHANG Yinhao(School of Public Health and Management,Ningria Medical University,Yinchuan 750004,China;Ningria Center for Disease Control and Prevention,Yinchuan 750000,China)
出处
《病毒学报》
CAS
CSCD
北大核心
2023年第3期783-790,共8页
Chinese Journal of Virology
基金
2017年宁夏青年拔尖人才项目(项目号:宁卫计函发{2018}178号)
2020年宁夏回国人员创新创业项目(项目号:宁人社函{2021}5号),题目:核酸定量检测在优化艾滋病一站式早期诊断中的应用。
关键词
HIV-1
异性传播
基因亚型
耐药
HIV-1
Heterosexual transmission
Genotype
Drug resistance
