摘要
目的了解吉林省HIV-1(human immunodeficiency virus-1,HIV-1)感染者治疗前基因型耐药及分子网络传播情况。方法选取2022年治疗前HIV感染者228名,提取血浆RNA、反转录PCR扩增HIV-1pol基因片段。建立进化树确定亚型、解析基因型耐药突变(drug resistance mutations,DRMs)情况并构建HIV分子网络评估传播关系。结果从228例样本中成功获得206条pol基因序列,基因亚型主要为CRF01AE(60.68%,125/206)、CRF07BC(30.10%,62/206)和B亚型(5.34%,11/206)。总耐药率为9.22%(19/206),耐药突变以非核苷逆转录酶抑制剂为主,占8.25%(17/206)。多因素logistic回归分析表明,40~49岁和≥50岁,离异或丧偶感染人群产生耐药的风险较高(P<0.05)。白城地区和CRF07BC感染者入网风险更大(P<0.05)。有63条序列入网(30.58%,63/206),形成23个分子簇。入网病例中6例携带DRMs。出现本市和跨市连接边关系。异性与同性性传播感染人群存在混合连接边。结论吉林省HIV感染者治疗前耐药率处于中等水平,分子网络中的毒株呈地区聚集性,加强耐药监测,对网络桥梁人群进行有针对性的干预措施,减少治疗前发生耐药传播的可能性。
ObjectiveTo understand the characteristics of drug resistance and molecular network transmission among pre-treatment human immunodeficiency virus-1(HIV-1)infected patients in Jilin province.MethodsTwo hundred and twenty-eight pre-treatment HIV infected patients in 2022 were recruited.Plasma RNA was extracted and pol gene fragment was amplified by reverse transcription-polymerase chain reaction(RT-PCR).The phylogenetic tree was reconstructed for subtype determination,drug-resistance mutations(DRMs)analysis.The molecular networks were constructed to evaluate the transmission relationship.ResultsTwo hundred and six sequences were obtained successfully from the 228 samples.The main subtypes were CRF01_AE(60.68%,125/206),CRF07_BC(30.10%,62/206)and B(5.34%,11/206).The overall drug-resistance rate was 9.22%(19/206),and the DRMs were mainly associated with from non-nucleoside reverse transcriptase inhibitors(NNRTIs),accounting for 8.25%(17/206).Multivariable logistic regression analysis showed that the risk of drug resistance were higher in groups of 40-49 years old,≥50 years old and divorced or widowed individuals(P<0.05).The infected people in Baicheng city and patients with CRF07_BC infection were more likely to access the network(P<0.05).There were 63 sequences enrolled in the network and formed 23 molecular clusters(30.58%,63/206).Among the cases in the network,6 cases carried DRMs.There existed the"intra-city"and"inter-city"connection relationships and a mixing junction between heterosexual and homosexual transmission groups.ConclusionsThe drug resistance rate of pre-treatment HIV infected patients was at moderate level,and the virus strains clustered by geographical regions.The surveillance of drug resistance should be enhanced.The targeted intervention measures for the bridge-population should be applied to reduce the possibility of pre-treatment drug-resistance transmission.
作者
郭琪
王岙
冯毅
吴东林
齐晓晨
王慧
臧希卉
刘思含
邢辉
孙柳燕
Guo Qi;Wang Ao;Feng Yi;Wu Donglin;Qi Xiaochen;Wang Hui;Zang Xihui;Liu Sihan;Xing HuiSun Liuyan(Virology Laboratory of Jilin Procincial Center for Disease Control and Prevention(Jilin Provincial Institute of Preventive Medicine),Changchun 130062,China;National Center for AIDS/STD Control and Prevention,Chinese Center for Disease Control and Prevention,Beijing 102206,China)
出处
《国际病毒学杂志》
北大核心
2024年第4期270-274,共5页
International Journal of Virology
基金
吉林省科技计划项目(20230203021SF)。
关键词
艾滋病病毒
治疗前耐药
传播性耐药
分子网络
Human immunodeficiency virus
Pretreatment drug resistance
Transmitted drug resistance
Molecular network
