2016 年至 2018 年期间中国东北地区沈阳市新诊断 HIV 感染者中替诺福韦/恩曲他滨耐药的传播。

Transmitted drug resistance to Tenofovir/Emtricitabine among persons with newly diagnosed HIV infection in Shenyang city, Northeast China from 2016 to 2018.

机构信息

National Clinical Research Center for Laboratory Medicine, NHC Key Laboratory of AIDS Immunology (China Medical University), The First Affiliated Hospital of China Medical University, No 155, Nanjing North Street, Heping District, Shenyang, 110001, Liaoning Province, China.

Key Laboratory of AIDS Immunology, Chinese Academy of Medical Sciences, Shenyang, 110001, China.

出版信息

BMC Infect Dis. 2021 Jul 9;21(1):668. doi: 10.1186/s12879-021-06312-3.

DOI:10.1186/s12879-021-06312-3

PMID:34243716

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC8268309/

Abstract

BACKGROUND

To assess transmitted drug resistance (TDR) to tenofovir (TDF)/emtricitabine (FTC), using as pre-exposure prophylaxis, among newly diagnosed human immunodeficiency virus-1 (HIV-1)-infected residents in Shenyang city, northeast China.

METHODS

Demographic and epidemiological information of all newly diagnosed HIV-1 infected residents in Shenyang city from 2016 to 2018 were anonymously collected from the local HIV epidemic database. HIV-1 pol sequences were amplified from RNA in cryopreserved plasma samples and sequenced directly. Viral subtypes were inferred with phylogenetic analysis and drug resistance mutations (DRMs) were determined according to the Stanford HIVdb algorithm. Recent HIV infection was determined with HIV Limiting Antigen avidity electro immunoassay.

RESULTS

A total of 2176 sequences (92.4%, 2176/2354) were obtained; 70.9% (1536/2167) were CRF01_AE, followed by CRF07_BC (18.0%, 391/2167), subtype B (4.7%, 102/2167), other subtypes (2.6%, 56/2167), and unique recombinant forms (3.8%, 82/2167). The prevalence of TDR was 4.9% (107/2167), among which, only 0.6% (13/2167) was resistance to TDF/FTC. Most of these subjects had CRF01_AE strains (76.9%, 10/13), were unmarried (76.9%, 10/13), infected through homosexual contact (92.3%, 12/13), and over 30 years old (median age: 33). The TDF/FTC DRMs included K65R (8/13), M184I/V (5/13), and Y115F (2/13). Recent HIV infection accounted for only 23.1% (3/13). Most cases were sporadic in the phylogenetic tree, except two CRF01_AE sequences with K65R (Bootstrap value: 99%).

CONCLUSIONS

The prevalence of TDR to TDF/FTC is low among newly diagnosed HIV-infected cases in Shenyang, suggesting that TDR may have little impact on the protective effect of the ongoing CROPrEP project in Shenyang city.

摘要

背景

评估在中国东北沈阳市新诊断的人类免疫缺陷病毒 1 型（HIV-1）感染者中，使用替诺福韦（TDF）/恩曲他滨（FTC）作为暴露前预防的传播药物耐药（TDR）。

方法

匿名从当地 HIV 流行数据库中收集 2016 年至 2018 年沈阳市新诊断的所有 HIV-1 感染居民的人口统计学和流行病学信息。从冷冻保存的血浆样本中扩增 HIV-1 pol 序列，并直接进行测序。通过系统发育分析推断病毒亚型，并根据斯坦福 HIVdb 算法确定耐药突变（DRMs）。使用 HIV 限性抗原亲和力电化学免疫测定法确定近期 HIV 感染。

结果

共获得 2176 条序列（92.4%，2176/2354）；70.9%（1536/2167）为 CRF01_AE，其次是 CRF07_BC（18.0%，391/2167）、亚型 B（4.7%，102/2167）、其他亚型（2.6%，56/2167）和独特重组形式（3.8%，82/2167）。TDR 的流行率为 4.9%（107/2167），其中仅 0.6%（13/2167）对 TDF/FTC 耐药。这些受试者主要为 CRF01_AE 株（76.9%，10/13），未婚（76.9%，10/13），经同性接触感染（92.3%，12/13），年龄超过 30 岁（中位年龄：33 岁）。TDF/FTC 的 DRMs 包括 K65R（8/13）、M184I/V（5/13）和 Y115F（2/13）。最近的 HIV 感染仅占 23.1%（3/13）。大多数病例在系统发育树上呈散在分布，除了两个带有 K65R 的 CRF01_AE 序列（Bootstrap 值：99%）。