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目的通过对广西壮族自治区南宁市2013-2014年HIV新发感染者毒株基因特征的研究,了解当地HIV毒株流行现状及耐药毒株传播情况。方法采集当年新确证16~25岁且未接受抗病毒治疗的部分HIV-1感染者血浆样本,提取病毒RNA,通过扩增HIV-1 pol区片段,进行测序和耐药突变分析。结果2年共获得pol区序列124条,主要以CRF01_AE为主(62.1%,77/124);其次也发现了CRF07_BC、CRF08_BC、CRF55_01B和B亚型等多种亚型毒株。共有9例样本(7.3%)出现了耐药突变,其中6例为异性传播,3例为同性传播,5例针对蛋白酶类抑制剂(PIs),2例针对非核苷类抑制剂(NNRTIs),另有2例针对核苷类抑制剂(NRTIs)发生耐药突变。结论当地流行毒株主要为CRF01_AE,在南宁首次发现多例CRF55_01B重组亚型。广西南宁HIV-1新发感染者耐药传播水平目前超过5%,应引起高度重视,需进一步加强对新近感染者传播性耐药株的监测。
Objective To investigate the prevalence of HIV strains and the spread of drug-resistant strains in Nanning, Guangxi Zhuang Autonomous Region from 2013 to 2014. Methods The plasma samples of some HIV-1 infected individuals aged 16-25 years who were newly diagnosed with no antiviral therapy were collected. The viral RNA was extracted and the HIV-1 pol region was amplified for sequence analysis and drug resistance mutation analysis. Results A total of 124 pol region sequences were obtained in 2 years, mainly CRF01_AE (62.1%, 77/124). A number of subtypes of CRF07_BC, CRF08_BC, CRF55_01B and B were also found. A total of 9 samples (7.3%) developed resistance mutations, of which 6 were heterosexual transmission, 3 were sexually transmitted, 5 were for protease inhibitors (PIs), 2 were for non-nucleoside inhibitors (NNRTIs) Another two cases were resistant mutations to nucleoside inhibitors (NRTIs). CONCLUSIONS: The majority of endemic strains are CRF01_AE and the first case of multiple CRF55_01B subtypes was found in Nanning. The prevalence of drug-resistant transmission in newly-infected HIV-1 patients in Nanning, Guangxi Province is currently over 5%, which should be given high priority. The monitoring of newly-infected transmissible drug-resistant strains needs to be further strengthened.