College of Medicine, University of the Philippines, Manila.
College of Public Health, University of the Philippines, Manila, The Philippines.
Int J Tuberc Lung Dis. 2021 Apr 1;25(4):285-291. doi: 10.5588/ijtld.20.0878.
TB is the leading cause of death from a single infectious disease, particularly among people living with HIV (PLHIV). Molecular epidemiology provides information on prevalent genotypes of and disease transmission dynamics, which aid in TB control. Identification of mutations that confer drug resistance is essential for the rapid diagnosis of drug-resistant TB, especially in high TB burden settings, like the Philippines. This study aimed to determine mutations in drug resistance-conferring genes and circulating genotypes in PLHIV. MIRU-VNTR (mycobacterial interspersed repetitive unit-variable number of tandem repeats) typing using a set of 24-loci and sequencing of drug resistance-conferring genes were performed in 22 isolates from TB-HIV co-infected patients. The prevalence of resistance to any drug was 31.8%, 18.2% for isoniazid monoresistance, 4.5% for streptomycin monoresistance and 9.1% for multidrug resistance. The identified mutations in the GBAL and A genes have been reported in the literature; none was found in the A and B genes. All isolates belonged to the EAI2-Manila family and were grouped into four clusters based on their phenotypic drug resistance and mutation profiles. The use of 24-loci set may be used as a more discriminatory MIRU-VNTR typing in settings where the East African-Indian lineage is predominant, like the Philippines.
结核病是由单一传染病引起的主要死亡原因，尤其是在艾滋病毒感染者（PLHIV）中。分子流行病学提供了关于和疾病传播动态的流行基因型的信息，有助于结核病控制。鉴定赋予药物耐药性的突变对于快速诊断耐药结核病至关重要，特别是在菲律宾等结核病负担高的环境中。本研究旨在确定 PLHIV 中与药物耐药性相关的基因突变和循环基因型。对来自结核病合并 HIV 感染患者的 22 株分离株进行了 24 个基因座的 MIRU-VNTR（分枝杆菌插入重复单元-可变数量串联重复）分型和耐药性相关基因的测序。任何药物耐药的患病率为 31.8%，异烟肼单耐药为 18.2%，链霉素单耐药为 4.5%，多药耐药为 9.1%。在 GBAL 和 A 基因中鉴定出的突变已在文献中报道；在 A 和 B 基因中均未发现。所有分离株均属于 EAI2-Manila 家族，并根据其表型药物耐药性和突变谱分为四个群集。在以东非-印度谱系为主的菲律宾等环境中，使用 24 个基因座集可能是一种更具鉴别力的 MIRU-VNTR 分型方法。
