台州市2016-2018年新报告HIV/AIDS抗病毒治疗前HIV-1耐药及亚型流行特征分析

徐璐璐; 沈伟伟; 陈潇潇; 李桂霞; 许圆圆; 高眉扬; 周素娟; 林海江; 何纳

Abstract

徐璐璐,沈伟伟,陈潇潇,李桂霞,许圆圆,高眉扬,周素娟,林海江,何纳.台州市2016-2018年新报告HIV/AIDS抗病毒治疗前HIV-1耐药及亚型流行特征分析[J].Chinese journal of Epidemiology,2021,42(4):711-715

台州市2016-2018年新报告HIV/AIDS抗病毒治疗前HIV-1耐药及亚型流行特征分析

HIV-1 drug resistance and subtypes in newly reported HIV/AIDS patients before antiretroviral therapy in Taizhou city, 2016-2018

Received:July 06, 2020

DOI：10.3760/cma.j.cn112338-20200706-00926

KeyWord: 艾滋病病毒/艾滋病亚型耐药

English Key Word: HIV/AIDS Subtype Drug resistance

FundProject:国家科技重大专项（2018ZX10721102-004）；上海市卫生健康委课题（GWTD2015S05）

Author Name	Affiliation	E-mail
Xu Lulu	Department of Epidemiology, School of Public Health, Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai 200032, China
Shen Weiwei	Taizhou City Center for Disease Control and Prevention, Taizhou 318000, China
Chen Xiaoxiao	Taizhou City Center for Disease Control and Prevention, Taizhou 318000, China
Li Guixia	Taizhou City Center for Disease Control and Prevention, Taizhou 318000, China
Xu Yuanyuan	Taizhou City Center for Disease Control and Prevention, Taizhou 318000, China
Gao Meiyang	Department of Epidemiology, School of Public Health, Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai 200032, China
Zhou Sujuan	Department of Epidemiology, School of Public Health, Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai 200032, China
Lin Haijiang	Taizhou City Center for Disease Control and Prevention, Taizhou 318000, China	fudanlhj@qq.com
He Na	Department of Epidemiology, School of Public Health, Key Laboratory of Public Health Safety, Ministry of Education, Fudan University, Shanghai 200032, China	nhe@fudan.edu.cn

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Abstract:

目的了解台州市新报告HIV/AIDS抗病毒治疗（ART）前HIV-1耐药情况及亚型流行特点。方法于2016年1月至2018年12月在台州市开展新报告HIV/AIDS在ART前HIV-1耐药的横断面调查，RT-PCR扩增获得HIV-1 pol基因片段并测序，提交序列至斯坦福大学耐药数据库，根据2014年WHO耐药监测指南的推荐标准，确定耐药突变位点以及HIV-1毒株对抗病毒药物的敏感性。结果 2016-2018年台州市新报告HIV/AIDS中成功获得HIV-1 pol基因区序列的研究对象806例，ART前HIV-1耐药率为2.9%（23/806），其中，非核苷类反转录酶抑制剂（NNRTIs）、核苷类反转录酶抑制剂（NRTIs）和蛋白酶抑制剂（PIs）耐药率分别为1.9%（15/806）、0.6%（5/806）和0.0%。2016-2018年新报告HIV/AIDS在ART前HIV-1耐药率依次分别为1.6%、1.8%和4.8%。NNRTIs和NRTIs耐药突变位点以K103 N（0.7%）和M184I/V（0.5%）为主。HIV-1亚型以CRF01_AE（42.7%，344/806）、CRF07_BC（28.9%，233/806）和CRF08_BC（11.2%，90/806）为主。同性性传播者HIV-1亚型以CRF01_AE（53.3%，136/255）和CRF07_BC（32.2%，82/255）为主；异性性传播者HIV-1亚型以CRF01_AE（37.7%，203/539）、CRF07_BC（27.5%，148/539）和CRF08_BC（16.1%，87/539）为主。结论 2016-2018年台州市新报告HIV/AIDS在ART前HIV-1耐药率处于低流行状态，但存在上升趋势，需加强对HIV-1耐药型毒株的监测工作。

English Abstract:

Objective To explore the HIV-1 drug resistance and subtypes in newly reported HIV/AIDS patients before antiretroviral therapy (ART) in Taizhou city. Methods A cross-sectional study of HIV-1 drug resistance was conducted among newly reported HIV/AIDS patients before ART in Taizhou from January 2016 to December 2018. HIV-1 pol gene sequences were obtained by RT-PCR. The sequences were submitted to the Stanford University drug resistance database. The drug resistance mutation and the sensitivity of HIV-1 strains to antiretroviral drugs were determined according to WHO Guidelines on HIV drug resistance surveillance of 2014. Results A total of 806 HIV-1 pol gene sequences were obtained successfully. The overall HIV-1 drug resistance rate was 2.9% (23/806), 1.9% for non-nucleoside reverse transcriptase inhibitors (NNRTIs), 0.6% for nucleoside reverse transcriptase inhibitors (NRTIs), and 0.0% for protease inhibitors (PIs), respectively. From 2016 to 2018, the HIV-1 drug resistance rate was 1.6%, 1.8%, and 4.8%, respectively. The resistance mutations of NNRTIs and NRTIs were mainly K103 N (0.7%) and M184I/V (0.5%). HIV-1 subtypes were mostly CRF01_AE (42.7%,344/806),CRF07_BC (28.9%,233/806) and CRF08_BC (11.2%,90/806).HIV-1 subtypes among homosexually transmitted infections were mostly CRF01_AE (53.3%, 136/255) and CRF07_BC (32.2%, 82/255), and HIV-1 subtypes among heterosexually transmitted infections were mainly CRF01_AE (37.7%, 203/539), CRF07_BC (27.5%, 148/539) and CRF08_BC (16.1%, 87/539). Conclusion HIV-1 drug resistance rate among newly reported HIV/AIDS patients before ART remained low in Taizhou during 2016 to 2018, an increasing trend seemed to be notifiable and warrants continuous surveillance of HIV-1 drug resistance.

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