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

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

Abstract

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].Chinese journal of Epidemiology,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

Received:November 16, 2014

DOI：10.3760/cma.j.issn.0254-6450.2015.06.010

KeyWord: 艾滋病病毒基因型耐药警戒线抗病毒治疗德宏州

English Key Word: HIV Genotype Drug resistance threshold survey Antiretroviral therapy Dehong prefecture

FundProject:国家科技重大专项(2012ZX10001-002)

Author Name	Affiliation	E-mail
Ma Yanling	Yunnan Provincial Center for Disease Control and Prevention, Kunming 650022, China
Wang Jibao	Dehong Center for Disease Control and Prevention
Xing Hui	National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention
Chen Min	Yunnan Provincial Center for Disease Control and Prevention, Kunming 650022, China
Yao Shitang	Dehong Center for Disease Control and Prevention
Chen Huichao	Yunnan Provincial Center for Disease Control and Prevention, Kunming 650022, China
Yang Jin	Dehong Center for Disease Control and Prevention
Li Yanling	Dehong Center for Disease Control and Prevention
Duan Song	Dehong Center for Disease Control and Prevention	dhduansong@sina.com
Jia Manhong	Yunnan Provincial Center for Disease Control and Prevention, Kunming 650022, China	jiamanhong@hotmail.com

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Abstract:

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.

English Abstract:

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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