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目的了解2012年临沧市未经抗病毒治疗的艾滋病病毒Ⅰ型(HIV-1)感染者中,病毒的基因型分布和耐药株传播水平。方法根据HIV-1耐药警戒线调查实施方案,对2012年2-7月,临沧市符合方案要求的50份年龄在18-25岁的、新发现的HIV-1感染者的血浆样本,进行耐药基因型检测和耐药株传播水平分析。结果 50份血浆样本中,36份完成了基因型及耐药鉴定。通过进化分析对pol区进行分型,75.0%(27/36)的样本为CRF08_BC,其他依次为URF_BC(8.3%,3/36)、CRF07_BC(5.6%,2/36)、CRF01_AE(5.6%,2/36)和C亚型(5.6%,2/36)。URF_BC重组中有两例重组模式相同。获得的序列中未检测到监测相关的耐药突变(Surveillance drug resistance mutations,SDRM),按照耐药警戒线的统计方法估算,耐药株流行率<5%。结论临沧市目前主要流行的HIV-1亚型为CRF08_BC,HIV-1耐药株处于低度流行水平。为控制耐药传播水平的上升,在加强重点人群艾滋病防治的基础上,应加强规范艾滋病抗病毒治疗及科学管理,同时有计划地开展相关的耐药监测。
Objective To understand the distribution of genotypes and the transmission of drug-resistant strains of HIV-1 in Lincang City in 2012 without anti-virus treatment. Methods According to the HIV-1 drug resistant cordon survey implementation plan, from January to July in 2012, the clinical samples of 50 HIV-1 newly discovered HIV-1 infected individuals aged 18-25 years in Lincang, Analysis of resistant genotypes and transmission of drug-resistant strains. Results Of the 50 plasma samples, 36 completed the genotype and drug resistance evaluation. The genotypes of pol region were analyzed by evolutionary analysis. The samples of 75.0% (27/36) were CRF08_BC, followed by URF_BC (8.3%, 3/36), CRF07_BC (5.6%, 2/36), CRF01_AE 2/36) and subtype C (5.6%, 2/36). Two of the URF_BC recombination recombination patterns are the same. No anti-drug-resistant mutations (SDRMs) were detected in the obtained sequences, and the prevalence of drug-resistant strains was less than 5% according to the statistical method of drug resistance warning line. Conclusion The prevalence of HIV-1 subtype in Lincang is CRF08_BC, and the HIV-1 resistant strains are at low prevalence level. To control the rise of drug-resistant transmission, on the basis of strengthening AIDS prevention and treatment of key populations, we should step up the regulation of AIDS anti-virus treatment and scientific management, and carry out related drug resistance surveillance in a planned manner.