文章摘要
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gagpolenv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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