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目的了解丽水市人类免疫缺陷病毒Ⅰ型(human immunodeficiency virus-1,HIV-1)感染人群病毒基因型及耐药情况。方法收集未经抗病毒药物治疗的307例新报告病例血浆及经过药物治疗的79例既往感染者血浆,提取核酸检测病毒载量,同时巢式PCR扩增病毒pol区基因片段,对扩增成功样本进行测序、拼接并提交至耐药数据库进行基因型耐药分析。结果 269例基因扩增成功,CRF01_AE型为主要型别,占44.98%。57例存在主要耐药基因突变,28例显示耐药,新报告病例人群耐药率为5.04%(13/258),既往感染人群耐药率为11.39%(9/79)。耐药突变位点为I54IM、K65N、L100I、Y181C、M184V等引起的高度或中度耐药,Q58E、L23I、F77L、G190E等引起低度或潜在耐药。结论丽水市HIV-1耐药传播为中流行(5%~10%)水平,应加强耐药监测。耐药突变位点及耐受药物多样化,应警惕I54M、K70E、M184V、K103N等位点突变引起的FPV、3TC、EFV、NVP耐药。
Objective To investigate the genotypes and drug resistance of human immunodeficiency virus-1 (HIV-1) infected in Lishui City. Methods A total of 307 newly reported cases of plasma and drug-treated plasma from 79 previously untreated patients were collected and nucleic acids were extracted for detection of viral load. The nested PCR was used to amplify the gene fragment of the pol gene of the virus, Samples were sequenced, stitched and submitted to the drug resistance database for genotypic drug resistance analysis. Results 269 cases of gene amplification was successful, CRF01_AE type as the main type, accounting for 44.98%. In 57 cases, there were major resistance mutations and 28 cases showed drug resistance. The rate of new drug resistance was 5.04% (13/258) in the newly reported cases and 11.39% (9/79) in the previously infected cases. The drug-resistant mutation sites were highly or moderately resistant to I54IM, K65N, L100I, Y181C, M184V, etc., causing low or potential drug resistance such as Q58E, L23I, F77L, G190E. Conclusion The transmission of HIV-1 resistance in Lishui City is in the prevalence (5% -10%) level, and drug resistance monitoring should be strengthened. Drug-resistant mutation sites and drug-resistant diversification, should be alert to I54M, K70E, M184V, K103N mutations caused by FPV, 3TC, EFV, NVP resistance.