icddr,b: International Centre for Diarrhoeal Disease Research, Bangladesh.
icddr,b: International Centre for Diarrhoeal Disease Research, Bangladesh.
Int J Infect Dis. 2021 Mar;104:150-158. doi: 10.1016/j.ijid.2020.12.037. Epub 2020 Dec 30.
HIV-1 subtyping data of Bangladeshi strains are available in global HIV Sequence Database up to 2007, and there is no sequence of drug resistance profile based on the pol gene segment. This study aimed to update HIV genotyping data and describe the drug resistance mutations for the first time from Bangladesh using specimens from the latest HIV sero-surveillance conducted in 2016.
During HIV sero-surveillance, a total of 1268 people who inject drugs (PWID) and 3765 female sex workers (FSW) were screened and among them, 230 (18.1%) PWID and 7 (0.2%) FSW were HIV positive. Among HIV positives, randomly selected 74 specimens (60 male-PWID, 7 female-PWID, and 7 FSW) were subjected to gag, pol, and env gene sequencing using gene-specific primers. Genotyping was decided based on the partial gag and env genes while transmission dynamics was based on the gag sequence (n = 237). Drug resistance profiles were obtained by using the algorithm of the established available drug resistance database.
HIV subtype C and C-related recombinants have remained the major circulating genotypes in Bangladesh. Although the recurring transmission of subtype C occurred among PWID, we identified possible transmission to other key populations (KPs), which suggests spillover from PWID through the sexual route. The prevalence of drug-resistant mutation was low, and all strains were susceptible to NRTIs and NNRTIs drugs. Unique recombination forms (URF) with genotype C for gag-pol and A1 for env was also identified.
The study findings warrant continuous monitoring of HIV-positive individuals and future investigation to identify social networks within and between KPs to halt the transmission and prevent new infections.
截至 2007 年，全球 HIV 序列数据库中已有孟加拉国 HIV-1 亚型数据，但基于 pol 基因片段尚无耐药性分析数据。本研究旨在利用 2016 年最新 HIV 血清监测中采集的标本，更新 HIV 基因分型数据，并首次对孟加拉国的耐药突变情况进行描述。
在 HIV 血清监测期间，共对 1268 名注射吸毒者（PWID）和 3765 名性工作者（FSW）进行了筛查，其中 230 名 PWID（18.1%）和 7 名 FSW（0.2%）HIV 阳性。在 HIV 阳性者中，随机选择 74 份标本（60 名男性 PWID、7 名女性 PWID 和 7 名 FSW），使用基因特异性引物对 gag、pol 和 env 基因进行测序。根据部分 gag 和 env 基因进行基因分型，根据 gag 序列（n = 237）进行传播动力学分析。耐药性分析通过已建立的耐药数据库算法获得。
HIV 亚型 C 和 C 相关重组仍然是孟加拉国主要流行的基因型。尽管 PWID 中存在亚型 C 的反复传播，但我们发现可能向其他关键人群（KP）传播，这表明 PWID 可能通过性途径传播。耐药突变的流行率较低，所有毒株对 NRTIs 和 NNRTIs 类药物均敏感。还发现了 gag-pol 为基因型 C 和 env 为 A1 的独特重组形式（URF）。
本研究结果表明，需要对 HIV 阳性个体进行持续监测，并进一步调查以确定 KP 内部和之间的社交网络，以阻止传播和预防新的感染。
