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目的了解浙江省绍兴市新确诊HIV-1感染者传播性耐药情况。方法分析2013年-2014年绍兴地区新确认未经抗病毒治疗的130例HIV-1感染者样本,采用逆转录PCR和巢氏PCR方法扩增HIV-1的pol基因区全长,构建系统进化树分析基因亚型,参照美国斯坦福大学HIV耐药数据库,确定HIV耐药突变位点及其对各种抗逆转录病毒药物的敏感性。结果共90例样品获得合格的pol区序列结果,发现CRF01_AE、CRF07_BC、CRF08_BC、B和重组亚型CRF01_AE/CRF07_BC 5种亚型。34例样品出现耐药突变,占37.78%;7例样品同时存在2个耐药突变,均为次要耐药位点,其中CRF01_AE亚型4例,CRF07_BC、CRF08_BC和B亚型各1例;27例样品出现1个耐药突变,其中主要耐药位点突变11例(12.22%),次要耐药位点突变23例(25.56%)。NNRTIs的耐药突变位点包括V179D/E、K103N;蛋白酶区的次要耐药突变位点有A71V、L10I、L31I、I47M;整合酶区的次要耐药突变位点包括L74I/M、L68V、E157Q、A128T。结论绍兴市HIV原发耐药突变率相对较高,HIV病毒有较高的潜在耐药性,应加强监测。
Objective To understand the transmission resistance of newly diagnosed HIV-1 infected patients in Shaoxing City, Zhejiang Province. Methods A total of 130 samples of HIV-1 infected newly diagnosed in Shaoxing from 2013 to 2014 were analyzed. RT-PCR and nested PCR were used to amplify the full-length pol gene region of HIV-1 to construct a phylogenetic tree Tree analysis of gene subtypes, with reference to the Stanford University HIV drug resistance database, to determine HIV-resistant mutations and their susceptibility to various antiretroviral drugs. Results A total of 90 samples obtained qualified pol region sequence results, found CRF01_AE, CRF07_BC, CRF08_BC, B and recombinant subtypes CRF01_AE / CRF07_BC five subtypes. 34 samples showed resistance mutations, accounting for 37.78%. There were 2 resistance mutations in 7 samples simultaneously, which were all secondary resistance sites. There were 4 CRF01_AE subtypes, 1 CRF07_BC, 1 CRF08_BC and 1 subtype B; There were 1 resistant mutations in 27 samples, of which 11 (12.22%) were major drug resistance mutations and 23 (25.56%) were secondary drug resistance mutations. The resistant mutations in NNRTIs included V179D / E and K103N. The minor resistance mutations in protease region were A71V, L10I, L31I and I47M. The minor resistance mutations in the integrase region included L74I / M and L68V , E157Q, A128T. Conclusion The mutation rate of HIV primary in Shaoxing is relatively high. HIV virus has high potential drug resistance and should be monitored intensively.