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中国深圳新诊断的HIV-1感染者的基因型、耐药性及分子传播网络特征

Characteristics of genotype, drug resistance, and molecular transmission network among newly diagnosed HIV-1 infections in Shenzhen, China.

作者信息

Li Minchao, Zhou Jiasheng, Zhang Kechun, Yuan Yue, Zhao Jiacong, Cui Mingting, Yin Di, Wen Ziyu, Chen Zhonghe, Li Linghua, Zou Huachun, Deng Kai, Sun Caijun

机构信息

School of Public Health (Shenzhen), Shenzhen Campus of Sun Yat-sen University, Shenzhen, China.

Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China.

出版信息

J Med Virol. 2023 Jul;95(7):e28973. doi: 10.1002/jmv.28973.

Abstract

The HIV-1 pandemic has persisted for four decades, and poses a major challenge to global public health. Shenzhen, a city with large number of migrant populations in China, is suffering HIV-1 epidemic. It is necessary to continuously conduct the molecular surveillance among newly diagnosed HIV-1 patients in these migrant population. In this study, plasma samples of newly diagnosed and ART-naive HIV-1 infections were collected from Shenzhen city in China. The partial genes of HIV-1 gag and pol were amplified and sequenced for the analysis of genotype, drug resistance, and molecular transmission network. Ninety-one sequences of pol gene were obtained from newly diagnosed HIV-1 infections in Shenzhen, and seven HIV-1 subtypes were revealed in this investigation. Among them, the circulating recombinant form (CRF) 07_BC was the mostly frequent subtype (53.8%, 49/91), followed by CRF01_AE (20.9%, 19/91), CRF55_01B (9.9%, 9/91), unique recombinant forms (URFs) (8.8%, 8/91), B (3.3%, 3/91), CRF59_01B (2.2%, 2/91), and CRF08_BC (1.1%, 1/91). The overall prevalence of pretreatment drug resistance (PDR) was 23.1% (21/91), and 52.38% (11/21) of the PDR was specific for the nonnucleotide reverse transcriptase inhibitors (NNRTIs). Furthermore, a total of 3091 pol gene sequences were used to generate 19 molecular transmission clusters, and then one growing cluster, a new cluster, and a cluster with growth reactivation were identified. The result revealed that more sexual partner, CRF_07BC subtype, and seven amino acid deletions in gag p6 region might be the influencing factors associated with the high risk of transmission behavior. Compared with CRF01_AE subtype, CRF07_BC subtype strains were more likely to form clusters in molecular transmission network. This suggests that long-term surveillance of the HIV-1 molecular transmission should be a critical measure to achieve a precise intervention for controlling the spread of HIV-1 in China.

摘要

人类免疫缺陷病毒1型(HIV-1)大流行已持续了四十年,对全球公共卫生构成了重大挑战。深圳是中国一个拥有大量流动人口的城市,正遭受着HIV-1疫情的困扰。有必要持续对这些流动人口中新诊断的HIV-1患者进行分子监测。在本研究中,从中国深圳市收集了新诊断且未接受抗逆转录病毒治疗(ART)的HIV-1感染者的血浆样本。对HIV-1 gag和pol基因的部分片段进行扩增和测序,以分析基因型、耐药性和分子传播网络。从深圳新诊断的HIV-1感染者中获得了91条pol基因序列,本调查揭示了7种HIV-1亚型。其中,流行重组型(CRF)07_BC是最常见的亚型(53.8%,49/91),其次是CRF01_AE(20.9%,19/91)、CRF55_01B(9.9%,9/91)、独特重组型(URF)(8.8%,8/91)、B(3.3%,3/91)、CRF59_01B(2.2%,2/91)和CRF08_BC(1.1%,1/91)。治疗前耐药(PDR)的总体患病率为23.1%(21/91),其中52.38%(11/21)的PDR是针对非核苷类逆转录酶抑制剂(NNRTI)的。此外,共使用3091条pol基因序列生成了19个分子传播簇,然后鉴定出一个增长簇、一个新簇和一个有增长再激活的簇。结果显示,性伴侣较多、CRF_07BC亚型以及gag p6区域的七个氨基酸缺失可能是与高传播风险行为相关的影响因素。与CRF01_AE亚型相比,CRF07_BC亚型毒株在分子传播网络中更易形成簇。这表明对HIV-1分子传播进行长期监测应是在中国实现精准干预以控制HIV-1传播的关键措施。

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