文章摘要
韩志刚,张亚丽,吴昊,高凯,赵宇腾,古羽舟,陈韵聪.广州市2008-2015年未接受抗病毒治疗的男男性行为人群艾滋病病毒感染者耐药分析[J].中华流行病学杂志,2018,39(7):977-982
广州市2008-2015年未接受抗病毒治疗的男男性行为人群艾滋病病毒感染者耐药分析
Prevalence of drug resistance in treatment-naive HIV infected men who have sex with men in Guangzhou, 2008-2015
投稿时间:2017-10-14  
DOI:10.3760/cma.j.issn.0254-6450.2018.07.021
中文关键词: 艾滋病病毒;男男性行为人群;耐药
英文关键词: HIV;Men who have sex with men;Drug resistance
基金项目:广州市科技计划项目(201707010184,201704020219)
作者单位E-mail
韩志刚 510440 广州市疾病预防控制中心业务管理部 zhiganghan616@163.com 
张亚丽 510310 广州, 广东药科大学公共卫生学院  
吴昊 510440 广州市疾病预防控制中心艾滋病预防控制部  
高凯 510440 广州市疾病预防控制中心艾滋病预防控制部  
赵宇腾 510440 广州市疾病预防控制中心艾滋病预防控制部  
古羽舟 510440 广州市疾病预防控制中心艾滋病预防控制部  
陈韵聪 510440 广州市疾病预防控制中心艾滋病预防控制部  
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中文摘要:
      目的 了解广州市未接受抗病毒治疗的MSM人群HIV感染者(MSM感染者)耐药株流行状况。方法 收集2008-2015年新确证HIV-1抗体阳性、现住址为广州市、传播途径为男男性行为传播、确证时未接受过抗病毒治疗的MSM感染者血清样本,提取HIV-1 RNA,采用巢式PCR法扩增HIV-1 pol区全部蛋白酶(PR)和部分反转录酶(RT)基因片段,测序后提交到美国斯坦福大学HIV耐药数据库进行耐药分析。结果 2 283例MSM感染者中,共有1 986例血清样本成功获得pol区基因片段,年龄16~84(30.18±8.24)岁;未婚者占74.17%(1 473/1 986);汉族占90.64%(1 800/1 986);大专及以上占49.65%(986/1 986),高中及中专占27.14%(539/1 986),初中及以下占20.89%(415/1 986)。HIV-1亚型以CRF07_BC和CRF01_AE为主,分别为38.22%(759/1 986)和34.49%(685/1 986)。总耐药率为3.32%(66/1 986),对蛋白酶抑制剂(PIs)耐药率为1.36%(27/1 986)),对核苷类反转录酶抑制剂(NRTIs)耐药率为0.65%(13/1 986),对非核苷类反转录酶抑制剂(NNRTIs)耐药率为1.61%(32/1 986)。B亚型对3类药物的耐药率均较高,CRF55_01B对NNRTIs耐药率高于其他亚型。B亚型对司他夫定(D4T)、依非韦仑(EFV)、奈韦拉平(NVP)的耐药率最高,均为4.17%(5/120);其次是那非那韦(NFV)、齐多夫定(AZT)、利匹韦林(RPV),均为3.33%(4/120)。CRF55_01B对EFV、NVP的耐药率最高,均为5.50%(16/291);其次是依曲韦林(ETR)、RPV,均为5.15%(15/291)。结论 广州市未接受抗病毒治疗的MSM感染者耐药率处于低水平,现有抗病毒药物在总体上仍是有效的。但B亚型和CRF55_01B亚型耐药率相对较高,值得关注。
英文摘要:
      Objective To understand the prevalence of drug resistance in treatment-naive HIV infected men who have sex with (MSM) in Guangzhou. Methods HIV-1 RNA were extracted from the serum specimens of the MSM newly confirmed to be HIV-1 positive, living in Guangzhou and receiving no anti-viral therapy from 2008 to 2015. HIV-1 pol gene segments, including full protease and part reverse transcriptase, were amplified by nested reverse transcription polymerase chain reaction (nested-PCR) and sequenced by Sanger. Subsequently, the sequence data were submitted to Stanford University HIV Drug Resistance Database for drug resistance analysis. Results Among 2 283 HIV infected MSM, HIV-1 pol gene segments were obtained from the serum samples of 1 986 HIV infected MSM aged 16-84 (30.18±8.24) years. Among them, the unmarried accounted for 74.17% (1 473/1 986), those of Han ethnic group accounted for 90.64% (1 800/1 986), those with education level of college or above accounted for 49.65% (986/1 986), those with education level of senior high school or secondary school accounted for 27.14% (539/1 986), those with education level of junior high school or below accounted for 20.89% (415/1 986). The distribution of subtypes was predominated by CRF07_BC (38.22%, 759/1 986) and CRF01_AE (34.49%, 685/1 986). The overall prevalence of drug resistance was 3.32% (66/1 986). The prevalence of resistance to protease inhibitors (PIs), nucleoside reverse transcriptase inhibitors (NRTIs) and non-nucleoside reverse transcriptase inhibitors (NNRTIs) were 1.36%(27/1 986), 0.65% (13/1 986) and 1.61% (32/1 986), respectively. Subtype B had higher resistance to PIs, NRTIs and NNRTIs and subtype CRF55_01B had highest resistance to NNRTIs compared with other subtypes. In subtype B, the resistant rates to D4T, EFV and NVP were highest (all 4.17%, 5/120), followed by those to NFV, AZT and RPV (all 3.33%, 4/120). In subtype CRF55_01B, the resistant rates to EFV and NVP were highest (all 5.50%, 16/291),followed by those to ETR and RPV (all 5.15%, 15/291). Conclusions The prevalence of drug resistance in treatment-naive HIV infected MSM in Guangzhou remained at low level and current antiretroviral drugs are generally effective. However, subtype B and CRF55_01B have higher drug resistance.
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