Xie M, Lin L, Wang Z, Qiu Y, Lu X, Zhang C, Wu S
Fujian Provincial Center for Disease Control and Prevention, Fuzhou, Fujian 350012, China.
Fujian Provincial Key Laboratory of Zoonosis Research, Fuzhou, Fujian 350012, China.
Zhongguo Xue Xi Chong Bing Fang Zhi Za Zhi. 2023 Dec 1;35(6):583-589. doi: 10.16250/j.32.1374.2023003.
To investigate the HIV-1 genotype and distribution of newly diagnosed HIV-1 cases in Fujian Province in 2020, so as to provide insights into formulation of the precise AIDS control strategy in the province.
Newly diagnosed HIV-1 cases without antiretroviral therapy (excluding AIDS patients) were randomly sampled from each city of Fujian Province in 2020 at a proportion of 50% of the mean number of HIV-infected cases reported across 9 cities of Fujian Province during the past three years. Subjects' demographic and epidemiological data were collected and blood samples were collected. The HIV-1 pol gene was amplified using nested reverse-transcription PCR assay, and the gene sequences were used for HIV-1 genotyping and phylogenetic analysis. The gene sequences were uploaded to the HIV Drug Resistance Database (http://hivdb.stanford.edu) for genotypic drug resistance assays, and the scores and level of HIV drug resistance were estimated using the HIVDB Algorithm version 9.5.
A total of 1 043 newly diagnosed HIV-1 cases were reported in Fujian Province in 2020, and 936 gene sequences were successfully obtained following sequencing of blood samples. There were 9 HIV-1 genotypes characterized in blood samples from 936 newly diagnosed HIV-1 cases, with CRF07_BC (52.1%) and CRF01_AE (30.4%) as predominant subtypes, followed by CRF08_BC (4.9%), CRF55_01B (3.0%), subtype C (2.5%), subtype B (2.1%), CRF85_BC (1.7%), CRF59_01B (0.3%) and CRF65_CPX (0.1%), and unidentified subtypes were found in 26 blood samples. HIV-1 drug resistance was detected in 43 out of the 936 newly diagnosed HIV-1 cases, with 4.6% prevalence of HIV-1 drug resistance prior to therapy, and the highest drug resistance was found in the HIV CRF59_01B subtype, followed by in CRF08_BC, B, C, CRF01_AE, CRF07_BC and other subtypes, with a significant difference in the genotype-specific prevalence of HIV-1 drug resistance (χ = 45.002, < 0.05).
There was a HIV-1 genotype diversity in Fujian Province in 2020, and emerging recombinant and drug-resistant HIV-1 strains were detected and spread across patients and regions. Monitoring of HIV-1 genotypes is recommended to be reinforced for timely understanding of the transmission and spread of novel recombinant and drug-resistant HIV-1 strains.
调查2020年福建省新诊断HIV-1病例的基因型及分布情况，为制定该省精准的艾滋病防控策略提供依据。
从福建省各城市随机抽取2020年新诊断且未接受抗逆转录病毒治疗的HIV-1病例（不包括艾滋病患者），抽取比例为福建省9个城市过去三年报告的HIV感染病例平均数的50%。收集研究对象的人口统计学和流行病学数据，并采集血样。采用巢式逆转录PCR法扩增HIV-1 pol基因，将基因序列用于HIV-1基因分型及系统发育分析。将基因序列上传至HIV耐药数据库（http://hivdb.stanford.edu）进行基因型耐药检测，使用HIVDB算法9.5版评估HIV耐药分数及水平。
2020年福建省共报告1043例新诊断HIV-1病例，血样测序后成功获得936条基因序列。936例新诊断HIV-1病例的血样中鉴定出9种HIV-1基因型，以CRF07_BC（52.1%）和CRF01_AE（30.4%）为主要亚型，其次为CRF08_BC（4.9%）、CRF55_01B（3.0%）、C亚型（2.5%）、B亚型（2.1%）、CRF85_BC（1.7%）、CRF59_01B（0.3%）和CRF65_CPX（0.1%），26份血样中发现未鉴定的亚型。936例新诊断HIV-1病例中43例检测到HIV-1耐药，治疗前HIV-1耐药率为4.6%，HIV CRF59_01B亚型耐药率最高，其次为CRF08_BC、B、C、CRF01_AE、CRF07_BC及其他亚型，HIV-1耐药的基因型特异性患病率差异有统计学意义（χ² = 45.002，P < 0.05）。
2020年福建省存在HIV-1基因型多样性，检测到新出现的重组及耐药HIV-1毒株，并在患者及地区间传播。建议加强HIV-1基因型监测，及时了解新型重组及耐药HIV-1毒株的传播情况。
