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目的了解福州市2015年新发HIV感染者/AIDS病例艾滋病病毒感染毒株的亚型流行特征及原发性耐药情况,为有效开展艾滋病监测和防控提供科学依据。方法 2016年采集2015年新发HIV感染者/AIDS病例的340份HIV阳性血样,送福建省疾病预防控制中心提取HIV核酸,通过PCR技术扩增HIV-1基因的env、gag、pol区域,将PCR产物测序后进行分析,确定其基因亚型;采用美国斯坦福大学HIV国际耐药数据库进行耐药分析。结果 340份样本中,241份基因扩增阳性,发现9种HIV-1亚型和重组亚型。其中CRF07-BC重组型116份、CRF01-AE重组型80份、B亚型11份、CRF55-01B重组型10份、CRF08-BC重组型5份、CRF68-01B重组型5份、C亚型1份、CRF33-01B重组型1份、未知重组型12份。241份中,共发现31例耐药者,占12.86%;包括对蛋白酶抑制剂(PIs)耐药的5份(占2.07%),对核苷类反转录酶抑制剂(NRTIs)耐药的3份(占1.25%),对非核苷类反转录酶抑制剂(NNRTIs)耐药的23份(占9.54%)。241份HIV-1阳性标本的CD4+T淋巴细胞绝对值计数为2~1 094个/μl,平均322.49个/μl(P>0.05)。结论福州市存在多种HIV-1亚型流行,以CRF07-BC和CRF01-AE为主要亚型;耐药监测发现PIs、NRTIs、NNRTIs耐药突变株。
Objective To understand the prevalence and primary drug resistance of HIV-infected strains of newly-infected HIV / AIDS cases in Fuzhou in 2015 and provide a scientific basis for effective AIDS surveillance and prevention. Methods In 2016, 340 HIV-positive blood samples from newly infected HIV / AIDS cases were collected and sent to Fujian Provincial Center for Disease Control and Prevention for HIV nucleic acid extraction. The env, gag and pol regions of HIV-1 gene were amplified by PCR. The PCR products were sequenced and analyzed to determine their subgenotypes. The drug resistance was analyzed using the Stanford HIV international drug resistance database. Results Among the 340 samples, 241 genes were positive for amplification and 9 HIV-1 subtypes and recombinant subtypes were found. Among them, 116 were CRF07-BC recombinant, 80 were CRF01-AE, 11 were B, 10 were CRF55-01B, 5 were CRF08-BC, 5 were CRF68-01B, 1, CRF33-01B recombinant 1, unknown recombinant 12. Of the 241 patients, 31 were drug-resistant, accounting for 12.86%; 5 were resistant to protease inhibitors (PIs) (2.07%) and resistant to nucleoside reverse transcriptase inhibitors (NRTIs) (1.25%), and 23 (9.54%) were resistant to NNRTIs. The absolute counts of CD4 + T lymphocytes in 241 HIV-1 positive samples ranged from 2 to 1094 cells / μl with an average of 322.49 cells / μl (P> 0.05). Conclusions There are many HIV-1 subtypes in Fuzhou City, with CRF07-BC and CRF01-AE as the major subtypes. Drug-resistant surveillance showed PIs, NRTIs and NNRTIs resistant mutants.