| 戴洁,孙鹏艳,陈会超,董莉娟,金晓媚,李佑芳,王珏,杨朝军,杨敏,曾志君,马艳玲,陈敏.昆明市2018年男男性行为者HIV-1基因型及耐药特征分析[J].中华流行病学杂志,2020,41(8):1335-1340 |
| 昆明市2018年男男性行为者HIV-1基因型及耐药特征分析 |
| Characteristics of HIV-1 genotype and drug resistance among men who have sex with men in Kunming, 2018 |
| 收稿日期:2019-11-07 出版日期:2020-08-25 |
| DOI：10.3760/cma.j.cn112338-20191107-00792 |
| 中文关键词: 男男性行为者 艾滋病病毒 基因型 耐药 |
| 英文关键词: Men who have sex with men HIV Genotype Drug resistance |
| 基金项目:云南省科技人才和平台计划（2019HB053） |
| 作者 | 单位 | E-mail | | 戴洁 | 云南省疾病预防控制中心性病艾滋病防制所, 昆明 650022 | | | 孙鹏艳 | 云南省疾病预防控制中心性病艾滋病防制所, 昆明 650022 | | | 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 | | | 董莉娟 | 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 | | | 李佑芳 | 云南省疾病预防控制中心性病艾滋病防制所, 昆明 650022 | | | 王珏 | 云南省疾病预防控制中心性病艾滋病防制所, 昆明 650022 | | | 杨朝军 | 云南省疾病预防控制中心性病艾滋病防制所, 昆明 650022 | | | 杨敏 | 云南省疾病预防控制中心性病艾滋病防制所, 昆明 650022 | | | 曾志君 | 云南省疾病预防控制中心性病艾滋病防制所, 昆明 650022 | | | 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 | | | 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2018年昆明市MSM的HIV-1基因型及耐药特征。方法 收集昆明市2018年1-12月新报告HIV-1感染的MSM的血浆样品193份，提取病毒RNA，采用巢式PCR扩增gag、pol和env区基因片段，进行基因分型和耐药分析，通过Bayesian Markov Chain Monte Carlo（MCMC）方法分析昆明市MSM感染者中CRF55_01B和CRF68_01B的进化特征。结果 193份样品中发现多个HIV-1基因型，包括CRF07_BC（39.4%，76/193）、CRF01_AE（34.2%，66/193）、独特型重组（20.2%，39/193）、CRF08_BC（3.1%，6/193）、CRF55_01B（1.6%，3/193）、B亚型（1.0%，2/193）和CRF68_01B（0.5%，1/193）。Bayesian进化分析结果显示CRF55_01B从外省进入昆明市后已开始在本地传播，而CRF68_01B可能来自于我国东部地区。2018年昆明市MSM抗病毒治疗前的HIV-1耐药株流行率为2.6%（5/190），对非核苷类反转录酶抑制剂的耐药突变发生率最高（2.1%，4/190）。结论 昆明市MSM的HIV-1基因型多样性逐年增加。MSM未接受抗病毒治疗HIV-1感染者耐药发生率虽然较低，但存在抗病毒治疗一线药物的多重耐药株。 |
| 英文摘要: |
| Objective To understand the characteristics of HIV-1 genotypes and drug resistance among men who have sex with men in Kunming in 2018. Methods A total of 193 plasma samples were collected from the newly reported HIV-1 infected MSM in Kunming from January to December 2018. Viral RNA was extracted, and the gag, pol, env gene segments were amplified by nested PCR. HIV-1 genotypes and drug resistance were also analyzed. Subsequently, the evolutionary characteristics of CRF55_01B and CRF68_01B among MSM in Kunming were analyzed by Bayesian Markov Chain Monte Carlo method. Results Multiple HIV-1 genotypes were identified among these 193 samples, including CRF07_BC (39.4%, 76/193), CRF01_AE (34.2%, 66/193), unique recombinant forms (URFs) (20.2%, 39/193), CRF08_BC (3.1%, 6/193), CRF55_01B (1.6%, 3/193), subtype B (1.0%, 2/193) and CRF68_01B (0.5%,1/193). Results from the Bayesian evolutionary analysis showed that CRF55_01B started to spread locally after being imported from other provinces, while CRF68_01B was likely to have been brought in from the eastern provinces of China. Prevalence of HIV-1 drug resistant strains was 2.6%(5/190) before antiviral treatment, with mutation rates resistant to non-nucleoside reverse transcriptase inhibitors being the highest (2.1%, 4/190) among MSM in Kunming, 2018. Conclusion The diversity of HIV-1 was increasing among MSM in Kunming. Although the resistance rate on pretreatment drug was relatively low, the emergence of multiple resistant strains to first-line antiviral drugs posed a challenge to antiretroviral therapy, in Kunming. |
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