Zhang Dong, Zheng Chenli, Li Hanping, Li Hao, Liu Yongjian, Wang Xiaolin, Jia Lei, Chen Lin, Yang Zhengrong, Gan Yongxia, Zhong Yifan, Han Jingwan, Li Tianyi, Li Jingyun, Zhao Jin, Li Lin
Department of AIDS Research, State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Academy of Military Medical Sciences, Beijing, 100071 China.
Shenzhen Center for Disease Control and Prevention, Shenzhen, Guangdong 518055, China.
J Infect. 2021 Jul;83(1):76-83. doi: 10.1016/j.jinf.2021.04.021. Epub 2021 Apr 28.
Shenzhen is suffering severe HIV epidemic. No systematic surveillance on high risk populations, HIV genetic diversity, transmitted drug resistance (TDR) and molecular transmission clusters (MTCs) have been reported yet. In this study, we described them based on newly diagnosed HIV positive cases from 2011 to 2018 in Shenzhen city, China.
Plasma samples of newly reported HIV positive cases in Shenzhen, China were collected from 2011 to 2018. The HIV pol gene was amplified and sequenced for subtyping, genetic characterization, TDR and phylogenetic analysis. Demographic and risk characteristics associated with transmitted drug resistance-associated mutations (TDRAMs) and MTCs were explored by using logistic regression analyses.
10,378 HIV pol sequences were successfully obtained from newly diagnosed patients with available background information. The most prevalent HIV-1 subtype was CRF07_BC (40.92%). CRF07_BC, CRF55_01B and URFs increased across years. Total TDR was 6.02% during 2011 to 2018. CRF01_AE, CRF08_BC, CRF55_01B and subtype B were more likely to be associated with TDRAMs than CRF07_BC. 4460 (42.98%) patients were infected with strains included in MTCs. Patients younger than 30 and over 50 years were more likely to cluster.
The prevalence of HIV-1 drug resistance and molecular transmission clusters in Shenzhen should raise a high alert. Interventions targeting on patients with strains locating in MTCs should be considered to improve prevention effect in Shenzhen.
深圳正遭受严重的艾滋病疫情。目前尚未有对高危人群、HIV基因多样性、传播性耐药（TDR）和分子传播簇（MTC）进行系统监测的报道。在本研究中，我们基于2011年至2018年在中国深圳市新诊断的HIV阳性病例对上述情况进行了描述。
收集了2011年至2018年在中国深圳新报告的HIV阳性病例的血浆样本。对HIV pol基因进行扩增和测序，以进行亚型分析、基因特征分析、TDR分析和系统发育分析。通过逻辑回归分析探索与传播性耐药相关突变（TDRAM）和MTC相关的人口统计学和风险特征。
从具有可用背景信息的新诊断患者中成功获得了10378条HIV pol序列。最常见的HIV-1亚型是CRF07_BC（40.92%）。CRF07_BC、CRF55_01B和未定型重组形式（URF）逐年增加。2011年至2018年期间总TDR为6.02%。与CRF07_BC相比，CRF01_AE、CRF08_BC、CRF55_01B和B亚型更有可能与TDRAM相关。4460名（42.98%）患者感染了MTC中的毒株。30岁以下和50岁以上的患者更有可能聚类。
深圳HIV-1耐药性和分子传播簇的流行应引起高度警惕。应考虑针对感染MTC中毒株的患者进行干预，以提高深圳的预防效果。
