文章摘要
马艳玲,王继宝,邢辉,陈敏,姚仕堂,陈会超,杨锦,李艳玲,段松,贾曼红.云南省德宏州2013年HIV-1耐药毒株传播警戒线调查结果分析[J].中华流行病学杂志,2015,36(6):584-588
云南省德宏州2013年HIV-1耐药毒株传播警戒线调查结果分析
Analysis on HIV-1 genetics and threshold of drug resistance in Dehong prefecture of Yunnan province in 2013
收稿日期:2014-11-16  出版日期:2015-06-09
DOI:10.3760/cma.j.issn.0254-6450.2015.06.010
中文关键词: 艾滋病病毒;基因型;耐药警戒线;抗病毒治疗;德宏州
英文关键词: HIV;Genotype;Drug resistance threshold survey;Antiretroviral therapy;Dehong prefecture
基金项目:国家科技重大专项(2012ZX10001-002)
作者单位E-mail
马艳玲 650022 昆明, 云南省疾病预防控制中心性病艾滋病防制所  
王继宝 德宏州疾病预防控制中心  
邢辉 中国疾病预防控制中心性病艾滋病预防控制中心  
陈敏 650022 昆明, 云南省疾病预防控制中心性病艾滋病防制所  
姚仕堂 德宏州疾病预防控制中心  
陈会超 650022 昆明, 云南省疾病预防控制中心性病艾滋病防制所  
杨锦 德宏州疾病预防控制中心  
李艳玲 德宏州疾病预防控制中心  
段松 德宏州疾病预防控制中心 dhduansong@sina.com 
贾曼红 650022 昆明, 云南省疾病预防控制中心性病艾滋病防制所 jiamanhong@hotmail.com 
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中文摘要:
      目的 调查2013年云南省德宏州未经抗病毒治疗的HIV-1感染者的基因型分布和耐药毒株传播水平.方法 根据HIV耐药警戒线调查实施方案,对2013年1-8月德宏州符合要求的54份年龄在16~25岁,新发现的HIV-1感染者的血浆样本进行HIV-1基因型检测和耐药毒株传播水平分析.结果 48份样本完成了基因型及耐药鉴定,中国籍占45.8%,缅甸籍占54.2%.通过进化分析对pol区进行分型,主要的基因型包括:C亚型(41.7%)、URF(31.3%)、CRF01_AE(12.5%)、CRF07_BC(10.4%)、CRF08_BC(2.1%)和B亚型(2.1%).中国籍感染者中首位的基因型是C亚型,而外籍感染者中首位的基因型是URF.在1份缅甸籍样本序列中检测到1个针对非核苷类反转录酶抑制剂类药物的耐药突变位点(K103N),按照耐药警戒线的统计方法估算耐药毒株流行率为< 5%.结论 本次调查提示德宏州新报告的HIV-1感染者中存在复杂的基因型,HIV-1耐药毒株处于低度流行水平.为控制耐药传播水平的上升,应进一步规范本地艾滋病抗病毒治疗及管理,并针对跨境传播开展包括耐药传播在内的相关监测.
英文摘要:
      Objective To study the HIV-1 genotypes and transmitted drug resistance (TDR) in Dehong prefecture of Yunnan province in 2013. Methods Referring to the guidelines for HIV drug resistance threshold survey(HIVDR-TS),54 plasma samples of recently reported HIV-infected individuals,aged between 16 and 25 years,were collected in Dehong prefecture from January to August 2013. Genotyping of partial pol gene was performed by using reverse transcriptional PCR. HIV-1 genotype. Prevalent levels of HIV-1 drug resistance transmission were analyzed. Results Forty-eight plasma samples were successfully sequenced and analyzed.Among them,45.8% were Chinese and the rest 54.2% were all Burmese. Based on pol sequences,identified HIV genotypes included subtype C(41.7%),URF(31.3%),CRF01_AE(12.5%),CRF07_BC(10.4%),CRF08_BC(2.1%) and subtype B (2.1%),C subtype appeared dominated in Chinese while URF was dominated in Burmese. One drug resistant mutation to non-nucleoside reverse transcriptase inhibitors (NNRTIs) was detected in one sequence from Burmese. Based on the statistical method of HIVDR-TS,the prevalence of transmitted HIV-1 drug resistance was adjusted as < 5%. Conclusion Diverse HIV-1 genotypes were found in this study,and the current HIV-1 drug resistant strains transmission was catalogued as at low prevalence level,in Dehong. To prevent the increase of the prevalence of transmitted HIV-1 drug resistance,standard treatment and scientific management for people living with HIV/AIDS should be strictly followed. Meanwhile,relevant surveillance,including drug resistance surveillance should also be performed among cross-border migrant population.
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