Abstract
张然,董婷丽,梁雯丽,操召兵,解祯,刘康迈,于飞,傅更锋,张玉琪,王国永,马瞧勤,吴韶彬,李艳,董薇,江震,徐杰,吴尊友,姚均,潘品良,邱茂锋.我国6个省19个城市男男性行为人群HIV-1 基因亚型及抗病毒治疗前耐药分析[J].Chinese journal of Epidemiology,2022,43(4):523-527
我国6个省19个城市男男性行为人群HIV-1 基因亚型及抗病毒治疗前耐药分析
Analysis of HIV-1 genetic subtype and pretreatment drug resistance among men who have sex with men infected with HIV-1 from 19 cities of 6 provinces in China
Received:November 25, 2021  
DOI:10.3760/cma.j.cn112338-20211125-00918
KeyWord: 艾滋病病毒|男男性行为人群|基因亚型|抗病毒治疗前耐药
English Key Word: HIV|Men who have sex with men|Genetic subtype|Pretreatment drug resistance
FundProject:国家科技重大专项(2018ZX10721102-003-002,2018ZX10721102-003-008)
Author NameAffiliationE-mail
Zhang Ran National HIV Reference Laboratory, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China  
Dong Tingli Division of HIV Prevention and Intervention, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China  
Liang Wenli National HIV Reference Laboratory, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China  
Cao Zhaobing Division of HIV Prevention and Intervention, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China  
Xie Zhen Division of HIV Prevention and Intervention, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China  
Liu Kangmai Division of HIV Prevention and Intervention, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China  
Yu Fei Danlan Beijing Media Limited, Beijing 100020, China  
Fu Gengfeng Jiangsu Provincial Center for Disease Control and Prevention, Nanjing 210009, China  
Zhang Yuqi Hebei Provincial Center for Disease Control and Prevention, Shijiazhuang 050021, China  
Wang Guoyong Shandong Center for Disease Control and Prevention, Ji'nan 250014, China  
Ma Qiaoqin Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China  
Wu Shaobin Fujian Provincial Center for Disease Control and Prevention, Fuzhou 350012, China  
Li Yan Guangdong Provincial Center for Disease Control and Prevention, Guangzhou 511430, China  
Dong Wei Division of HIV Prevention and Intervention, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China  
Jiang Zhen Division of HIV Prevention and Intervention, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China  
Xu Jie Division of HIV Prevention and Intervention, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China  
Wu Zunyou Division of HIV Prevention and Intervention, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China  
Yao Jun National HIV Reference Laboratory, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China  
Pan Pinliang National HIV Reference Laboratory, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China  
Qiu Maofeng National HIV Reference Laboratory, National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing 102206, China qiumf@chinaaids.cn 
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Abstract:
      目的 分析我国6个省19个城市男男性行为人群(MSM)HIV-1基因亚型分布及抗病毒治疗前耐药情况。方法 2019年4-11月,在河北、山东、江苏、浙江、福建和广东6个省19个城市收集未接受抗病毒治疗MSM HIV-1感染者的血浆样本574份,提取RNA,反转录后经巢式PCR扩增HIV-1 pol基因区片段。PCR产物测序后进行序列分析,构建系统进化树判定病毒基因亚型,提交斯坦福耐药数据库分析耐药。结果 有479份样本PCR扩增成功并获得核酸序列,检出的HIV-1基因亚型有9种,其中CRF01_AE(43.4%)和CRF07_BC(36.3%)所占比例较大,随后依次为B(6.3%)、CRF55_01B(5.9%)、CRF59_01B(0.8%)、CRF65_cpx(0.8%)、CRF103_01B(0.4%)、CRF67_01B(0.4%)和CRF68_01B(0.2%);另有26份(5.5%)样本的基因亚型为未知亚型。不同省份之间的基因亚型构成比差异有统计学意义(χ2=44.141,P<0.001)。总体抗病毒治疗前耐药率为4.6%(22/479),其中对非核苷类反转录酶抑制剂、核苷类反转录酶抑制剂和蛋白酶抑制剂的耐药率分别为3.5%(17/479)、0.8%(4/479)和0.2%(1/479)。新近感染者的抗病毒治疗前耐药率高于长期感染者,差异有统计学意义(χ2=4.634,P=0.031)。结论 我国6个省19个城市MSM的HIV-1感染者中HIV-1基因亚型多样化,不同省份之间的基因亚型构成比不同;整体抗病毒治疗前耐药率处于低水平,但新近感染者的耐药率较高,建议重点加强此类人群的耐药监测。
English Abstract:
      Objective To investigate the distribution of HIV-1 genetic subtypes and pretreatment drug resistance (PDR) among men who have sex with men (MSM) from 19 cities of 6 provinces in China. Methods From April to November 2019, 574 plasma samples of ART-naive HIV-1 infected MSM were collected from 19 cities in Hebei, Shandong, Jiangsu, Zhejiang, Fujian, and Guangdong provinces, total ribonucleic acid (RNA) was extracted and amplified the HIV-1 pol gene region by nested polymerase chain reaction (PCR) after reverse transcription. Then sequences were used to construct a phylogenetic tree to determine genetic subtypes and submitted to the Stanford drug resistance database for drug resistance analysis. Results A total of 479 samples were successfully amplified by PCR. The HIV-1 genetic subtypes included CRF01_AE, CRF07_BC, B, CRF55_01B, CRF59_01B, CRF65_cpx, CRF103_01B, CRF67_01B, CRF68_01B and unrecognized subtype, which accounted for 43.4%, 36.3%, 6.3%, 5.9%, 0.8%, 0.8%, 0.4%, 0.4%, 0.2% and 5.5%, respectively. The distribution of genetic subtypes among provinces is statistically different (χ2=44.141, P<0.001). The overall PDR rate was 4.6% (22/479), the drug resistance rate of non-nucleoside reverse transcriptase inhibitors, nucleoside reverse transcriptase inhibitors, and protease inhibitors were 3.5% (17/479), 0.8% (4/479) and 0.2% (1/479), respectively. The PDR rate of recent infections was significantly higher than that of long-term infections (χ2=4.634, P=0.031). Conclusions The HIV-1 genetic subtypes among MSM infected with HIV-1 from 19 cities of 6 provinces in China are diverse, and the distribution of subtypes is different among provinces. The overall PDR rate is low, while the PDR rate of recent infections was significantly higher than that of long-term infections, suggesting the surveillance of PDR in recent infections should be strengthened.
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