论文部分内容阅读
目的了解上海市浦东新区2014—2015年进入治疗的HIV-1感染者的基因特性及耐药情况。方法以巢式RT-PCR方法扩增91份治疗前HIV-1感染者样品HIV-1聚合酶片段,测序,构建进化树并进行HIV-1基因亚型分析,将获得的核酸序列提交至斯坦福大学HIV耐药数据库进行耐药位点分析。结果 91份样品测序成功53份,其中CRF01_AE重组体占67.9%(36/53),B亚型占7.5%(4/53),C亚型占3.8%(2/53),CRF07_BC重组体占20.8%(11/53)。在53条基因序列中41条检测到与HIV-1蛋白酶抑制剂(PIs)和逆转录酶抑制剂(RTIs)相关的共计66个突变位点,其中4个耐药突变位点与非核苷类逆转录酶抑制剂(NNRTIs)及核苷类逆转录酶抑制剂(NRTIs)耐药相关,原发耐药率为7.5%(4/53);37条基因序列检测到的62个突变位点与HIV-1 PIs和RTIs继发耐药性突变或基因的多形态改变相关。结论 2014—2015年进入治疗的HIV-1感染者基因多种亚型并存,以CRF01_AE重组体为主。对基因序列发生的原发和继发耐药性突变应引起重视。
Objective To investigate the genetic characteristics and drug resistance of HIV-1 infected patients in Pudong New Area from 2014 to 2015 in China. Methods The HIV-1 polymerase fragment of 91 pre-treatment HIV-1 infected patients was amplified by nested RT-PCR and sequenced. The phylogenetic tree was constructed and analyzed for HIV-1 genomic subtypes. The obtained nucleic acid sequence was submitted to Stanford University HIV drug resistance database for drug resistance loci analysis. Results Of 91 samples sequenced successfully, 67 (36.9%) were CRF01_AE, 7.5% (4/53) were subtype B, 3.8% (2/53) were subtypes C, and CRF07_BC accounted for 67.9% 20.8% (11/53). Of the 53 gene sequences, 41 detected a total of 66 mutations associated with HIV-1 protease inhibitors (PIs) and reverse transcriptase inhibitors (RTIs), of which 4 were resistant to mutation Reverse transcriptase inhibitors (NNRTIs) and nucleoside reverse transcriptase inhibitors (NRTIs) resistant, the primary drug resistance rate was 7.5% (4/53); 62 of the 37 gene sequences were detected Related to HIV-1 PIs and RTIs with secondary drug resistance mutations or polymorphisms. Conclusion Multiple subtypes of HIV-1 co-infected patients who entered treatment between 2014 and 2015 co-exist with CRF01_AE recombinants. Attention should be paid to the primary and secondary drug resistance mutations in the gene sequence.