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目的:了解2015年江苏省的免疫缺陷病毒(HIV)耐药株传播水平和亚型分布。方法:采用WHO的截断序贯抽样法,在江苏省获得性免疫缺陷综合征(艾滋病)疫情主要发生地南京采集47例当年新报告25岁以下HIV感染者血样,提取病毒RNA,采用RT-PCR和巢式PCR扩增HIV-1 pol区片段,并进行传播型耐药基因型分析。结果:2015年调查对象的序列成功获得率为100%(47/47),亚型以CRF01_AE亚型为主(59.6%),其次依次为CRF07_BC(25.5%)、C亚型(6.4%例)和B亚型(2.1%),并在亚型分析中发现3例URFs。江苏省HIV耐药传播水平为低流行,47份样本中发现1份样本存在传播型耐药位点突变,为蛋白酶区耐药位点突变(M46I)。该例耐药个体感染途径为同性传播,亚型为CRF01_AE。此次抽样调查发现学生所占比例最大,为46.8%(22/47),已超过商业服务人员29.8%(14/47)的比例。传播途径除1例异性传播外,其余均为同性传播。结论:江苏省首次发现传播型耐药1例,说明耐药株已开始传播。虽仍为低流行,但应密切关注耐药株传播水平的趋势变化。学生逐渐成为25岁以下感染者的主要群体,扩大对该人群的检测咨询干预工作应成为艾滋病防控工作的重点。对男男性行为做好预防措施,是控制耐药株传播的关键。
Objective: To understand the transmission and subtype distribution of immunodeficiency virus (HIV) resistant strains in Jiangsu province in 2015. Methods: According to the WHO cut-off sequential sampling method, 47 newly diagnosed cases of HIV-infected persons under 25 years of age were collected from Nanjing, the main place where the acquired immunodeficiency syndrome (AIDS) And nested PCR amplification of HIV-1 pol region fragments, and transmission type resistance genotype analysis. Results: The success rate of the sequence was 100% (47/47) in 2015, subtype CRF01_AE was the main type (59.6%), followed by CRF07_BC (25.5%), C subtype (6.4%) And subtype B (2.1%), and 3 URFs were found in the subtype analysis. In Jiangsu province, the prevalence of HIV-resistant transmission was low prevalence. One sample of 47 samples was found to be a transmission-type drug-resistant mutation with protease-site mutation (M46I). The case of drug-resistant individuals infected with homosexual transmission, subtype CRF01_AE. The sample survey found that the largest proportion of students, 46.8% (22/47), has exceeded the proportion of 29.8% (14/47) of commercial service personnel. Apart from 1 case of transmission of heterosexual transmission, the rest are same-sex transmission. Conclusion: The first case of transmission-type drug resistance was found in Jiangsu Province, indicating that the drug-resistant strains have started to spread. Although still low prevalence, close attention should be paid to the trend of spread of drug-resistant strains. Students gradually become the major group of people under the age of 25, and expanding the detection and intervention of this population should be the focus of AIDS prevention and control work. Preventative measures against MSM are the key to controlling the spread of resistant strains.