天津市2014－2017年男男性行为人群艾滋病病毒感染者原发性耐药分析

郑敏娜; 宁铁林; 周宁; 赵璇; 李龙; 朱静瑾; 程绍辉

Abstract

郑敏娜,宁铁林,周宁,赵璇,李龙,朱静瑾,程绍辉.天津市2014－2017年男男性行为人群艾滋病病毒感染者原发性耐药分析[J].Chinese journal of Epidemiology,2018,39(5):619-624

天津市2014－2017年男男性行为人群艾滋病病毒感染者原发性耐药分析

Transmitted drug resistance among HIV infected men who have sex with men in Tianjin, 2014-2017

Received:October 31, 2017

DOI：10.3760/cma.j.issn.0254-6450.2018.05.015

KeyWord: 艾滋病病毒男男性行为人群原发性耐药

English Key Word: HIV Men have sex with men Transmitted drug resistance

FundProject:天津市卫生行业重点攻关项目（14KG119）；天津市疾病预防控制中心科技基金（CDCKY1602）

Author Name	Affiliation	E-mail
Zheng Minna	Department for AIDS/STD Control and Prevention, Tianjin Centers for Disease Control and Prevention, Tianjin 300011, China
Ning Tielin	Department for AIDS/STD Control and Prevention, Tianjin Centers for Disease Control and Prevention, Tianjin 300011, China
Zhou Ning	Department for AIDS/STD Control and Prevention, Tianjin Centers for Disease Control and Prevention, Tianjin 300011, China
Zhao Xuan	Department for AIDS/STD Control and Prevention, Tianjin Centers for Disease Control and Prevention, Tianjin 300011, China
Li Long	Department for AIDS/STD Control and Prevention, Tianjin Centers for Disease Control and Prevention, Tianjin 300011, China
Zhu Jingjin	Department for AIDS/STD Control and Prevention, Tianjin Centers for Disease Control and Prevention, Tianjin 300011, China
Cheng Shaohui	Department for AIDS/STD Control and Prevention, Tianjin Centers for Disease Control and Prevention, Tianjin 300011, China	chengshaohui@gmail.com

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Abstract:

目的了解2014－2017年天津市MSM人群HIV感染者（MSM感染者）原发性耐药（transmitted drug resistance，TDR）的流行特点和相关因素。方法收集2014－2017年天津市未经抗病毒治疗的MSM人群中HIV感染者的血浆样本共225例，采用巢式PCR法扩增pol区基因片段，进行基因型耐药检测和相关因素分析。结果 205例样本获得pol区基因序列，完成HIV亚型和耐药检测。基因型依次为CRF01_AE占53.2%（109/205），CRF07_BC占28.8%（59/205），B亚型占10.2%（21/205），CRF55_01B亚型占4.9%（10/205），其他独特型二代重组亚型占2.9%（6/205）。75例样本成簇分布在20个传播簇内，62.5%（10/16）的TDR样本分布在5个传播簇中。耐药株的TDR流行率为7.8%，2014－2017年每年的TDR流行率逐年上升，分别为3.9%（2/51）、5.7%（3/53）、9.6%（5/52）和12.2%（6/49），但差异无统计学意义（χ²=2.504，P=0.127），CRF01_AE亚型和B亚型TDR流行率最高，分别为3.4%（7/205）和2.9%（6/205）。TDR突变以非核苷酸反转录酶抑制剂（NNRTIs）为主，TDR流行率为6.3%（13/205），核苷酸反转录酶抑制剂（NRTIs）和蛋白酶抑制剂（PIs）的TDR流行率分别为1.5%（3/205）和1.0%（2/205）。结论天津市MSM感染者的TDR毒株的TDR流行形势较严重，需采取有针对性的预防和控制措施。

English Abstract:

Objective To understand prevalence and transmission of transmitted drug resistance (TDR) among HIV infected men who have sex with men (MSM) in Tianjin from 2014 to 2017. Methods A total of 225 blood samples were collected from HIV infected MSM in Tianjin from 2014 to 2017. Pol gene fragments were obtained by viral RNA extraction and nested PCR amplification. Phylogenetic and drug resistance analyses were conducted. Results A total of 205 samples were successfully sequenced and analyzed. Based on pol sequences, 53.2% (109/205), 28.8% (59/205), 10.2% (21/205), 4.9% (10/205) and 2.9% (6/205) of the samples were positive for HIV subtypes CRF01_AE, CRF07_BC, B, CRF55_01B and unique recombinant forms (URFs). Twenty transmission clusters, including 75 sequences, were identified and 62.5% (10/16) of sequences with TDR were in 5 clusters. The prevalence of TDR was 7.8% between 2014 and 2017. The annual prevalence rate increased from 3.9% (2/51) in 2014, 5.7% (3/53) in 2015, 9.6% (5/52) in 2016 to 12.2%(6/49) in 2017, the difference was not significant (χ²=2.504, P=0.127). CRF01_AE and B strains had high TDR prevalence (3.4%, 7/205) and (2.9%, 6/205), respectively. The TDR mutation was mainly NNRTIs, the TDR prevalence was 6.3% (13/205). In contract, the TDR prevalence of NRTIs and PIs were 1.5% (3/205) and 1.0% (2/205) respectively. Conclusion Results from this study suggested that the prevalence of HIV-1 TDR strains in MSM was serious in Tianjin. It is necessary to take effective prevention and control measures.

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