Ishizaki Azumi, Cuong Nguyen Hung, Thuc Pham Van, Trung Nguyen Vu, Saijoh Kiyofumi, Kageyama Seiji, Ishigaki Kyoko, Tanuma Junko, Oka Shinichi, Ichimura Hiroshi
Department of Hygiene, Kanazawa University, Graduate School of Medical Science, Kanazawa, Japan.
AIDS Res Hum Retroviruses. 2009 Feb;25(2):175-82. doi: 10.1089/aid.2008.0193.
We evaluated the prevalence and profile of antiretroviral treatment (ART)-associated resistance mutations among HIV-1 strains in northern Vietnam by genotypically analyzing strains isolated from ART-naive individuals in Hai Phong, a city in which HIV-1 is highly prevalent. Plasma samples were collected from injecting drug users (IDU, n = 760), female sex workers (FSW, n = 91), seafarers (n = 94), pregnant women (n = 200), and blood donors (n = 210), and screened for HIV-1 antibodies. Plasma viral RNA was extracted from HIV-1-positive samples, amplified by reverse transcriptase (RT)-PCR of protease and RT genes, and analyzed for genotypes and ART-associated resistance mutations. HIV-1 prevalence among IDU, FSW, seafarers, pregnant women, and blood donors was 35.9%, 23.1%, 0%, 0.5%, and 2.9%, respectively. Phylogenetic analyses revealed that the most prevalent HIV-1 subtype was CRF01_AE (98.3%), similar to strains prevalent in southern China. Four (1.4%) subtype B strains and one (0.3%) unique recombinant between subtypes B and C were also identified. We found protease inhibitor-associated major resistance mutations in one of the 294 cases analyzed (0.3%; mutation M46I). We found RT inhibitor-associated major resistance mutations in 7/273 cases (2.6%; one occurrence each of L74I, M184I, and K219E; three cases of K103N; and two cases of G190E). One CRF01_AE strain harboring a protease codon 35 insertion was first identified in Vietnam. Thus, monitoring of drug-resistant HIV-1 and establishment of a database are required for the proper selection of ART in Vietnam.
我们通过对从海防市（一个艾滋病病毒1型高度流行的城市）未接受抗逆转录病毒治疗的个体中分离出的毒株进行基因分型分析，评估了越南北部艾滋病病毒1型毒株中与抗逆转录病毒治疗（ART）相关的耐药突变的流行情况和特征。从注射吸毒者（n = 760）、女性性工作者（n = 91）、海员（n = 94）、孕妇（n = 200）和献血者（n = 210）中采集血浆样本，并筛查艾滋病病毒1型抗体。从艾滋病病毒1型阳性样本中提取血浆病毒RNA，通过蛋白酶和逆转录酶（RT）基因的逆转录酶（RT）-PCR进行扩增，并分析基因型和与ART相关的耐药突变。注射吸毒者、女性性工作者、海员、孕妇和献血者中的艾滋病病毒1型流行率分别为35.9%、23.1%、0%、0.5%和2.9%。系统发育分析显示，最流行的艾滋病病毒1型亚型是CRF01_AE（98.3%），与中国南方流行的毒株相似。还鉴定出4株（1.4%）B亚型毒株和1株（0.3%）B亚型和C亚型之间的独特重组毒株。在分析的294例病例中，有1例（0.3%；突变M46I）发现了与蛋白酶抑制剂相关的主要耐药突变。在273例病例中有7例（2.6%）发现了与RT抑制剂相关的主要耐药突变（L74I、M184I和K219E各出现1次；K103N出现3例；G190E出现2例）。在越南首次鉴定出1株携带蛋白酶密码子35插入的CRF01_AE毒株。因此，越南需要监测耐药艾滋病病毒1型并建立数据库，以便正确选择ART。
