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[广西新报告的≥50岁人类免疫缺陷病毒感染男性的基因亚型与治疗前耐药情况]

[Genetic Subtypes and Pretreatment Drug Resistance in the Newly Reported Human Immunodeficiency Virus-Infected Men Aged≥50 Years Old in Guangxi].

作者信息

Fang Ning-Ye, Wei Wen-Cui, Li Jian-Jun, Cen Ping, Feng Xian-Xiang, Yang Dong, Tang Kai-Ling, Liang Shu-Jia, Shao Yu-Lan, Lu Hua-Xiang, Jiang He, Meng Qin, Liu Shuai-Feng, Zhu Qiu-Ying, Chen Huan-Huan, Lan Guang-Hua, Yang Shi-Xiong, Zhou Li-Fang, Mo Jing-Lin, Ge Xian-Min

机构信息

Institute of HIV/AIDS Prevention and Control,Guangxi Zhuang Autonomous Region Center for Disease Prevention and Control,Nanning 530028,China.

Department of Clinical Examination,Guigang Center for Disease Control and Prevention,Guigang,Guangxi 537100,China.

出版信息

Zhongguo Yi Xue Ke Xue Yuan Xue Bao. 2023 Jun;45(3):399-404. doi: 10.3881/j.issn.1000-503X.15444.

Abstract

Objective To analyze the genetic subtypes of human immunodeficiency virus (HIV) and the prevalence of pretreatment drug resistance in the newly reported HIV-infected men in Guangxi. Methods The stratified random sampling method was employed to select the newly reported HIV-infected men aged≥50 years old in 14 cities of Guangxi from January to June in 2020.The pol gene of HIV-1 was amplified by nested reverse transcription polymerase chain reaction and then sequenced.The mutation sites associated with drug resistance and the degree of drug resistance were then analyzed. Results A total of 615 HIV-infected men were included in the study.The genetic subtypes of CRF01_AE,CRF07_BC,and CRF08_BC accounted for 57.4% (353/615),17.1% (105/615),and 22.4% (138/615),respectively.The mutations associated with the resistance to nucleoside reverse transcriptase inhibitors (NRTI),non-nucleoside reverse transcriptase inhibitors (NNRTI),and protease inhibitors occurred in 8 (1.3%),18 (2.9%),and 0 patients,respectively.M184V (0.7%) and K103N (1.8%) were the mutations with the highest occurrence rates for the resistance to NRTIs and NNRTIs,respectively.Twenty-two (3.6%) patients were resistant to at least one type of inhibitors.Specifically,4 (0.7%),14 (2.3%),4 (0.7%),and 0 patients were resistant to NRTIs,NNRTIs,both NRTIs and NNRTIs,and protease inhibitors,respectively.The pretreatment resistance to NNRTIs had much higher frequency than that to NRTIs (2.9% 1.3%;=3.929,=0.047).The prevalence of pretreatment resistance to lamivudine,zidovudine,tenofovir,abacavir,rilpivirine,efavirenz,nevirapine,and lopinavir/ritonavir was 0.8%, 0.3%, 0.7%, 1.0%, 1.3%, 2.8%, 2.9%, and 0, respectively. Conclusions CRF01_AE,CRF07_BC,and CRF08_BC are the three major strains of HIV-infected men≥50 years old newly reported in Guangxi,2020,and the pretreatment drug resistance demonstrates low prevalence.

摘要

目的 分析广西新报告HIV感染男性人群的人类免疫缺陷病毒(HIV)基因亚型及治疗前耐药流行情况。方法 采用分层随机抽样方法,选取2020年1月至6月广西14个市新报告的年龄≥50岁的HIV感染男性。通过巢式逆转录聚合酶链反应扩增HIV-1的pol基因并测序,分析耐药相关突变位点及耐药程度。结果 共纳入615例HIV感染男性。CRF01_AE、CRF07_BC和CRF08_BC基因亚型分别占57.4%(353/615)、17.1%(105/615)和22.4%(138/615)。对核苷类逆转录酶抑制剂(NRTI)、非核苷类逆转录酶抑制剂(NNRTI)和蛋白酶抑制剂耐药相关突变分别发生在8例(1.3%)、18例(2.9%)和0例患者中。对NRTIs耐药发生率最高的突变是M184V(0.7%),对NNRTIs耐药发生率最高的突变是K103N(1.8%)。22例(3.6%)患者对至少一种类型抑制剂耐药。其中,对NRTIs、NNRTIs、NRTIs和NNRTIs均耐药以及蛋白酶抑制剂耐药的患者分别为4例(0.7%)、14例(2.3%)、4例(0.7%)和0例。治疗前对NNRTIs的耐药频率远高于对NRTIs的耐药频率(2.9%比1.3%;χ² = 3.929,P = 0.047)。拉米夫定、齐多夫定、替诺福韦、阿巴卡韦、利匹韦林、依非韦伦、奈韦拉平和洛匹那韦/利托那韦治疗前耐药率分别为0.8%、0.3%、0.7%、1.0%、1.3%、2.8%、2.9%和0。结论 CRF01_AE、CRF07_BC和CRF08_BC是2020年广西新报告的年龄≥50岁HIV感染男性人群的三大主要毒株,治疗前耐药流行率较低。

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