| 冯连贵,王憨杰,韩梅,丁贤彬,蒋岩.重庆市男男性接触人群中HIV一1新近感染者耐药监测[J].Chinese journal of Epidemiology,2008,29(5):455-458 |
| 重庆市男男性接触人群中HIV一1新近感染者耐药监测 |
| Drug resistance among recent HIV-1 infected men who have sex with men in Chongqing municipality of China |
| Received:February 15, 2008 |
| DOI： |
| KeyWord: 艾滋病病毒 男男性接触者 发病率 耐药突变 |
| English Key Word: HIV Men who have sex with men Incidence Drug resistance |
| FundProject:卫生部2007年艾滋病防治应用性研究项目（WA-2007-03）；中美艾滋病防治合作项目（GAP 5U62PS022883-5） |
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| Abstract: |
| 目的 调查2006年重庆市男男性接触（MSM）人群的HIV感染率、估计该人群的发病率，并对新近感染的样本进行耐药检测。方法 通过同性爱者场所的业主、志愿者组织以“滚雪球“的方式招募未接受过抗病毒治疗的MSM进行横断面调查。用酶联免疫和蛋白印迹法进行HIV抗体检测，BED-酶联捕获试验（BED-CEIA）进行新近感染检测，并通过间接检测血清阳转后HIV-IgG抗体占总IgG的比例来检测HIV新近感染、估算HIV发病率。耐药检测采用Trugene HIV-1试剂盒扩增出靶HIV-1 pol区基因中288 bp的蛋白酶基因（PR）和630 bp的逆转录酶基因（RT）片段，所得片段进行序列分析，结果由Bayer公司基因型耐药突变解释规则[DR 3.7 IVD（2006/07/27）Guidelines 11.0（2005/12/15）]生成临床耐药报告和突变位点报告，同时序列提交Stanford HIVdb数据库进行判断，得到耐药评分结果。上述两种结果再与用Geno2pheno方法进行耐药性判定的结果比对。结果 重庆市MSM人群2006年HIV感染率为10.4%，估算发病率为7.98%。使用三种方法分析耐药情况，分别有1例、2例、1例出现逆转录酶区（PR）突变，导致其对蛋白酶类抑制剂（PI）产生耐药，得到的该人群流行毒株耐药率分别为4.55%、9.09%和4.55%。结论 重庆市MSM人群的发病率及感染率已处于较高水平，应予以密切关注，原发耐药水平目前尚处于较低水平。 |
| English Abstract: |
| Objective To evaluate the situation of HIV prevalence,incidence and drug resistance(DR)among recent HIV infected men who have sex with men(MSM)during the year of 2006.Methods A transect investigation was conducted through snowballing to recruite volunteers.HIV infected status was confirmed by ELISA and Western Blot(WB),the recent infected within 155 days were confirmed by BED-Capture ELISA Assay(BED-CEIA),which based on the principle that characteristics of the initial HIV antibody response in recent infections differs from those of established or long-term infections either by antibody titer,proportion,specificity,isotype or avidity.Bayer Trugene was applied to PCR the target sequence of HIV pol gene,and the sequences were analyzed to detect the prevalence of HIV gene mutation.Furthemore.HIV antiretroviral drug resistance among MSM was evaluated.The Results were analyzed through three Methods:Trugene DR 3.7 IVD(2006/07/27)Guidelines 1 1.0(2005/12/15)provided byBayer company,Stanford HIVdb and Gen02pheno.Results The prevalence and incidence of HIV among MSM were 10.4%and 7.98% PY,by three Methods.There was only 1 sample found to have occurred resistant Drimary mutation which could be inferred that the average DR ratio was 4.55%(1/22).Conclusion The incidence and prevalence of MSM in Chongqing were notable,and the mutation rate stands at a low level when comparing to researches conducted in developed countries.Secondary mutations appeared frequently,suggesting that more research need to be conducted to understand how HIV was transmitting among the carriers. |
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