| 陈会超,王继宝,邢辉,马艳玲,段星,戴洁,金晓媚,姚仕堂,段松,陈敏.德宏傣族景颇族自治州2017年HIV-1感染者抗病毒治疗前耐药和病毒基因亚型研究[J].中华流行病学杂志,2019,40(8):982-987 |
| 德宏傣族景颇族自治州2017年HIV-1感染者抗病毒治疗前耐药和病毒基因亚型研究 |
| Study on HIV-1 genetics and drug resistance among HIV infected individuals who initiated antiretroviral therapy in Dehong Dai and Jingpo autonomous prefecture, 2017 |
| 收稿日期:2019-02-27 出版日期:2019-08-19 |
| DOI：10.3760/cma.j.issn.0254-6450.2019.08.020 |
| 中文关键词: 艾滋病病毒 基因型 耐药 抗病毒治疗 |
| 英文关键词: HIV Genotype Drug resistance Antiretroviral therapy |
| 基金项目:国家自然科学基金（81560327） |
| 作者 | 单位 | E-mail | | 陈会超 | 云南省疾病预防控制中心性病艾滋病防制所, 昆明 650022 | | | 王继宝 | 德宏傣族景颇族自治州疾病预防控制中心艾滋病性病防治科, 芒市 678400 | | | 邢辉 | 中国疾病预防控制中心性病艾滋病预防控制中心病毒及免疫研究室, 北京 102206 | | | 马艳玲 | 云南省疾病预防控制中心性病艾滋病防制所, 昆明 650022 | | | 段星 | 德宏傣族景颇族自治州疾病预防控制中心艾滋病性病防治科, 芒市 678400 | | | 戴洁 | 云南省疾病预防控制中心性病艾滋病防制所, 昆明 650022 | | | 金晓媚 | 云南省疾病预防控制中心性病艾滋病防制所, 昆明 650022 | | | 姚仕堂 | 德宏傣族景颇族自治州疾病预防控制中心艾滋病性病防治科, 芒市 678400 | | | 段松 | 德宏傣族景颇族自治州疾病预防控制中心艾滋病性病防治科, 芒市 678400 | dhduansong@sina.com.cn | | 陈敏 | 云南省疾病预防控制中心性病艾滋病防制所, 昆明 650022 | chenminyx@126.com |
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| 中文摘要: |
| 目的 了解德宏傣族景颇族自治州（德宏州）抗病毒治疗（ART）前的HIV-1感染者基因型和耐药株的流行水平。方法 2017年1-6月在德宏州收集初始ART的HIV-1感染者170例，扩增pol基因，进行HIV-1基因分型和基因型耐药分析。结果 147份样品获得了pol基因，通过进化分析，发现12种HIV-1基因型，居于前3位包括C亚型（29.9%，44/147）、独特型重组形式（URFs）（27.2%，40/147）和CRF01_AE（19.7%，29/147），还检测到了近年该地区新鉴定出的流行重组形式（CRFs），包括CRF62_BC、CRF64_BC、CRF86_BC和CRF96_cpx。基因型在异性性传播和注射吸毒传播人群中的分布差异有统计学意义。发现耐药突变的比例为8.8%（13/147）。注射吸毒的HIV-1感染者中耐药株的比例（25.0%，8/32），高于异性性传播的HIV-1感染者（4.6%，5/109）（χ2=10.166，P=0.002）。结论 2017年德宏州初始ART的HIV-1感染者中病毒基因型高度复杂，HIV-1耐药株的流行达中度水平。 |
| 英文摘要: |
| Objective To understand the distribution of HIV-1 genotypes and the status of drug resistance among people living with HIV who had prepared to initiate antiretroviral therapy (ART) in Dehong Dai and Jingpo autonomous prefecture (Dehong). Methods A total of 170 adults with HIV were recruited in Dehong from January to June 2017, before initiating ART. HIV-1 pol genes were amplified and used to analyze the HIV-1 genotypes and drug resistance. Results A total of 147 samples were successfully sequenced. Based on the phylogenetic analysis, 12 HIV-1 genotypes were found among the subjects, including three predominant genotypes such as subtype C (29.9%, 44/147), unique recombinant forms (URFs) (27.2%, 40/147) and CRF01_AE (19.7%, 29/147). Circulating recombinant forms (CRFs) which were newly identified in this area in recent years were also found among these subjects, including CRF62_BC, CRF64_BC, CRF86_BC and CRF96_cpx. The distribution of HIV-1 genotypes between heterosexual transmission or intravenous drug use, showed statistical difference. Surveillance drug resistance mutations (SDRMs) were found among 8.8% (13/147) of the subjects. Proportion of drug resistant strains among injecting drug users (25.0%, 8/32) was higher than that among those heterosexual transmitted individuals (4.6%, 5/109, χ2=10.166, P=0.002). Conclusions Among people living with HIV-1 who had prepared to initiate ART, their HIV-1 genetics were highly complicated, with moderate prevalence rate of HIV-1 drug-resistant strains. |
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