男男性行为者、跨性别女性和女性性工作者中循环抗逆转录病毒药物耐药突变及HIV-1亚型的检测：越南2018 - 2020年HIV哨点监测加强系统的结果
Detection of Antiretroviral Drug-Resistant Mutations and HIV-1 Subtypes in Circulation Among Men Who Have Sex With Men, SEM Females, and Female Sex Workers: Results of Vietnam's HIV Sentinel Surveillance Plus System, 2018-2020.
作者信息
Ngo Hanh Hong Thi, Pham Tram Phuong Thi, Hoang Ha Thanh Thi, Bui Duc Hoang, Phan Huong Thu Thi, Nguyen Quoc Cuong, Duong Thanh Cong, Bui Hien Thu, Nguyen Ha Thanh Thi, Le Mai Quynh Thi, Dang Anh Duc, McFarland Willi, Truong Hong-Ha M, Pham Thang Hong
机构信息
National Institute of Hygiene and Epidemiology (NIHE), Hanoi, Vietnam.
Division of Global HIV and Tuberculosis (DGHT), U.S. Centers for Disease Control and Prevention (CDC), Hanoi, Vietnam.
出版信息
J Acquir Immune Defic Syndr. 2025 Jan 1;98(1):29-36. doi: 10.1097/QAI.0000000000003537.
BACKGROUND
HIV drug resistance can reduce the effectiveness of antiretroviral drugs in preventing morbidity and mortality, limit options for treatment, and prevention. Our study aimed to assess HIV-1 subtypes and HIV drug resistance among key populations in HIV Sentinel Surveillance Plus Behavior in 2018 and 2020.
METHODS
One-stage venue-based cluster sampling was used to recruit participants at hotspots identified for men who have sex with men (MSM) in 7 provinces and sexual minority females and female sex workers (FSW) in 13 provinces. Participants completed a standard questionnaire about risk and preventive behaviors, and antiretroviral therapy history, and provided intravenous blood for HIV testing. HIV drug resistance testing was conducted on HIV-positive samples with viral load >1000 copies/mL.
RESULTS
A total of 185 of 435 (42.5%) HIV-positive samples had viral load ≥1000 copies/mL, of which 130 of 136 from MSM and 26 of 49 from FSW were successfully sequenced. Six HIV-1 subtypes were detected (CRF01_AE, A, CRF07/08_BC, B, C, CRF25_cpx), with CRF01_AE (82.7%, 129/156) the most common. Drug resistance mutations were detected in 16.7% of participants overall (26/156), in 15.4% (20/130) of MSM, and in 23.1% (6/26) of FSW. Mutations associated with resistance to non-nucleoside reverse transcriptase inhibitor (NNRTI) were the most frequently detected (73.1%, 19/26). The high level of resistance was presented in NNRTI and nucleoside reverse transcriptase inhibitors classes. There are 10 major resistance mutations detected with nucleoside reverse transcriptase inhibitors (M184VI-25.0%, K65KR-50.0%, Y115F-25%), NNRTI (K103N-21.1%, E138A-10.5%, V106M-5.3%, K101E-5.3%, G190A-5.3%), protease inhibitors (L33F-40.0%, M46L-20.0%).
CONCLUSIONS
Vietnam's HIV Sentinel Surveillance Plus system identified an emerging strain of HIV-1 and mutations associated with resistance to multiple drug classes among MSM and FSW.
背景
HIV耐药性会降低抗逆转录病毒药物预防发病和死亡的效果，限制治疗和预防的选择。我们的研究旨在评估2018年和2020年HIV哨点监测加强行为中重点人群的HIV-1亚型和HIV耐药性。
方法
采用基于场所的单阶段整群抽样方法，在7个省份为男男性行为者（MSM）确定的热点地区以及13个省份的性少数女性和女性性工作者（FSW）中招募参与者。参与者完成了一份关于风险和预防行为以及抗逆转录病毒治疗史的标准问卷，并提供静脉血进行HIV检测。对病毒载量>1000拷贝/mL的HIV阳性样本进行HIV耐药性检测。
结果
435份HIV阳性样本中共有185份（42.5%）病毒载量≥1000拷贝/mL，其中MSM的136份样本中有130份、FSW的49份样本中有26份成功测序。检测到6种HIV-1亚型（CRF01_AE、A、CRF07/08_BC、B、C、CRF25_cpx），其中CRF01_AE最为常见（82.7%，129/156）。总体上16.7%的参与者（26/156）检测到耐药突变，MSM中为15.4%（20/130），FSW中为23.1%（6/26）。与非核苷类逆转录酶抑制剂（NNRTI）耐药相关的突变检测最为频繁（73.1%，19/26）。NNRTI类和核苷类逆转录酶抑制剂类呈现出较高水平的耐药性。检测到10种主要的核苷类逆转录酶抑制剂耐药突变（M184VI - 25.0%、K65KR - 50.0%、Y115F - 25%）、NNRTI类（K103N - 21.1%、E138A - 10.5%、V106M - 5.3%、K101E - 5.3%、G190A - 5.3%）、蛋白酶抑制剂类（L33F - 40.0%、M46L - 20.0%）。
结论
越南的HIV哨点监测加强系统在MSM和FSW中发现了一种新出现的HIV-1毒株以及与多种药物类别的耐药相关的突变。
Zotero 插件