Please wait a minute...
文章检索
预防医学  2021, Vol. 33 Issue (5): 446-450    DOI: 10.19485/j.cnki.issn2096-5087.2021.05.004
  论著 本期目录 | 过刊浏览 | 高级检索 |
温州市新报告HIV-1感染者治疗前耐药分析
朱传新1, 郑文力1, 金聪囡2, 苏菲菲3, 吴矛矛1, 孙宝昌1, 张佳峰4
1.温州市疾病预防控制中心微生物检验科,浙江 温州 325000;
2.温州医科大学检验医学院(生命科学学院);
3.温州市中心医院感染科;
4.浙江省疾病预防控制中心艾滋病防制所实验室
Pre-treatment drug resistance of newly reported HIV-1 infected individuals in Wenzhou
ZHU Chuanxin*, ZHENG Wenli, JIN Congnan, SU Feifei, WU Maomao, SUN Baochang, ZHANG Jiafeng
*Wenzhou Center for Disease Control, Prevention, Wenzhou, Zhejiang325000, China
全文: PDF(845 KB)  
输出: BibTeX | EndNote (RIS)      
摘要 目的 了解温州市2019年新报告艾滋病病毒Ⅰ型(HIV-1)感染者治疗前耐药(PDR)情况,为指导艾滋病抗病毒治疗提供依据。方法 选择温州市2019年新报告的232例尚未经抗反转录病毒治疗(ART)的HIV-1感染者为研究对象,采集血浆样本,提取HIV-1病毒RNA,采用反转录PCR和巢式PCR扩增pol区基因并测序,分析耐药突变位点及对非核苷类反转录酶抑制剂(NNRTIs)、核苷类反转录酶抑制剂(NRTIs)和蛋白酶抑制剂(PIs)的耐药情况。结果 获得199例未经ART治疗的HIV-1感染者的pol区基因序列,共检出8种基因亚型,以CRF07_BC和CRF01_AE为主,分别为94例和58例,占47.24%和29.15%;检出2种独特重组型毒株(URFs),分别为URF(CRF01_AE/BC)和URF(B/C)。PDR 16例,检出率为8.04%。耐药位点突变31例,占15.58%;其中针对NNRTIs、NRTIs和PIs耐药突变位点分别检出20例、2例和9例,占64.52%、6.45%和29.03%。NNRTIs耐药位点突变包括K101E、K103N/R、V106I、E138K、V179D/E/T、Y181C、G190A和H221Y,4例病例同时出现2个耐药位点突变;NRTIs耐药位点突变为V75M和M184V;PIs耐药位点突变为M46I、L33F和Q58E。对我国新上市的NNRTIs新药多拉韦林(DOR)检出2例耐药病例。结论 温州市2019年新报告HIV-1感染者PDR检出率为8.04%,以NNRTIs耐药为主;已出现对新药DOR的耐药,应加强耐药监测。
服务
把本文推荐给朋友
加入引用管理器
E-mail Alert
RSS
作者相关文章
朱传新
郑文力
金聪囡
苏菲菲
吴矛矛
孙宝昌
张佳峰
关键词 艾滋病病毒Ⅰ型抗反转录病毒治疗耐药基因序列    
AbstractObjective To know the pre-treatment drug resistance ( PDR ) status of newly reported human immunodeficiency virus type 1 ( HIV-1 ) infected individuals in Wenzhou, so as to provide guidance for antiretroviral therapy ( ART ). Methods Totally 232 plasma samples of newly reported HIV-1 infected individuals who had not received ART were collected in Wenzhou in 2019. Virus ( HIV-1 ) RNA was extracted, followed by reverse transcription PCR and nested PCR to amplify the pol region and sequence. Resistance mutations and resistance to non-nucleoside reverse transcriptase inhibitors ( NNRTIs ), nucleoside reverse transcriptase inhibitors ( NRTIs ) and protease inhibitors ( PIs ) was analyzed. Results The pol region sequences from 199 infected patients were obtained and the incidence of PDR was 8.04% ( 16/199 ). Eight genotypes were detected, including circulating recombinant forms ( CRFs ) CRF07_BC ( 47.24%, 94/199 ) and CRF01_AE ( 29.15%, 58/199 ) which were the dominant types. Two unique recombinant forms ( URFs ) were detected, namely URF( CRF01_AE/BC ) and URF( B/C ) . Thirty-one cases ( 15.58% 31/199 ) had drug-resistant mutations. For NNRTIs, NRTIs and PIs, 20 cases ( 64.52% ) , 2 cases ( 6.45% ) and 9 cases ( 29.03% ) with drug resistance mutations were detected, respectively. The resistance mutations to NNRTIs included K101E, K103N/R, V106I, E138K, V179D/E/T, Y181C, G190A and H221Y. Four cases each had two resistance mutations to NNRTIs. The resistance mutations to NRTIs were V75M and M184V. The resistance mutations to PIs were M46I, L33F and Q58E. For the newly released NNRTI drug Doravirine ( DOR ), two cases were found to have mutations of resistance. Conclusions The incidence of PDR among newly reported HIV-1 patients in Wenzhou is 8.04%, mainly caused by NNRTIs drug-resistant mutation. Resistance to the new drug DOR has emerged. The surveillance of drug resistance should continue to be strengthened.
Key wordshuman immunodeficiency virus type 1    antiretroviral therapy    drug resistance    gene sequence
收稿日期: 2020-12-30      出版日期: 2021-05-12
ZTFLH:  R512.91  
基金资助:温州市科技局项目(Y2020554,Y2020542)
通信作者: 张佳峰,E-mail:jfzhang@cdc.zj.com   
作者简介: 朱传新,中专,副主任技师,主要从事微生物检验工作
引用本文:   
朱传新, 郑文力, 金聪囡, 苏菲菲, 吴矛矛, 孙宝昌, 张佳峰. 温州市新报告HIV-1感染者治疗前耐药分析[J]. 预防医学, 2021, 33(5): 446-450.
ZHU Chuanxin, ZHENG Wenli, JIN Congnan, SU Feifei, WU Maomao, SUN Baochang, ZHANG Jiafeng. Pre-treatment drug resistance of newly reported HIV-1 infected individuals in Wenzhou. Preventive Medicine, 2021, 33(5): 446-450.
链接本文:  
http://www.zjyfyxzz.com/CN/10.19485/j.cnki.issn2096-5087.2021.05.004      或      http://www.zjyfyxzz.com/CN/Y2021/V33/I5/446
[1] 吴亚松,马烨.HIV耐药评估和预防策略[J].传染病信息,2017,30(6):351-354.
[2] World Health Organization. HIV drug resistance surveillance guidance: updated 2015[EB/OL].(2017-10-29)[2021-02-08].http://apps.who.int/iris/bitstream/10665/204471/1/9789241510097eng.pdf?ua=1.
[3] World Health Organization.Surveillance of HIV drug resistancein adults initiating antiretroviral therapy(Pre-treatment HIV drugresistance)[EB/OL].(2017-05-08)[2021-02-08].http://apps.who.int/iris/bitstream/10665/112802/1/9789241507196eng.pdf?ua=1.
[4] 刘佳,许巍,何翠,等.河南省新确证HIV感染者中HIV原发耐药状况研究[J].中华流行病学杂志,2016,37(5):643-647.
[5] 陈孙云,郭春辉,吴楠楠,等.江阴市HIV-1感染者亚型及原发耐药基因突变研究[J].中华实验和临床病毒学杂志,2018,32(4):377-381.
[6] World Health Organization.WHO HIV drug resistance report 2012[EB/OL].[2021-02-08].http://www.who.int/hiv/pub/drugresistance/report2012/en.
[7] ZHAO S,FENG Y,HU J,et al.Prevalence of transmitted HIV drug resistance in antiretroviral treatment naïve newly diagnosed individuals in China[J].Sci Rep,2018,8(1):12273.
[8] 叶振淼,金茜,王大勇,等.1985—2016年浙江省温州市艾滋病病毒感染者/艾滋病患者生存时间及影响因素分析[J].疾病监测,2017,32(7):557-562.
[9] ZHANG J,GUO Z,YANG J,et al.Genetic diversity of HIV-1 and transmitted drug resistance among newly diagnosed individuals with HIV infection in Hangzhou,China[J].J Med Virol,2015,87(10):1668-1676.
[10] 孙伟东,姜天俊,黄辉煌,等.北京地区HIV-1感染者治疗前耐药特征及2年抗病毒治疗效果研究[J].国际病毒学杂志,2020,27(3):224-227.
[11] XU Y,PENG X,PENG X,et al.Characterization of HIV-1 subtypes and transmitted drug resistance among treatment-naive HIV-infected individuals in Zhejiang, China, 2014-2017[J].Arch Virol,2018,163(8):2233-2237.
[12] 曹栋卿,赵丹燕,何婷婷,等.绍兴市HIV-1毒株的耐药变异研究[J].中国艾滋病性病,2017,23(4):284-287.
[13] World Health Organization.Consolidated guidelines on the use of antiretroviral drugs for treating and preventing HIV infection,recommendations for a public health approch,second edition,2016[EB/OL].(2019-11-06)[2021-02-08].https://www.who.int/hiv/pub/arv/arv-2016/en.
[14] 李敬云. HIV耐药的现状、挑战与应对[J].传染病信息,2019,32(6):490-495.
[15] 邵一鸣. HIV耐药监测策略和检测技术[M].北京:人民卫生出版社,2010.
[16] 李扬,邢辉.未治疗艾滋病患者中HIV耐药株的传播研究[J].中华微生物学和免疫学杂志,2016,36(7):540-544.
[17] 阮尉月清,刘家法,张米,等.云南省男男性行为人群HIV/AIDS病例抗病毒治疗失败基因型耐药分析[J].预防医学,2020,32(10):987-991,995.
[18] 谢小慧,于风婷,张霞,等.2019年北京地区HIV-1感染者传播性耐药情况[J].中国艾滋病性病,2020,26(6):579-583.
[19] STERRANTINO G,BORGHI V,CALLEGARO A P,et al.Prevalence of predicted resistance to doravirine in HIV-1-positive patients after exposure to non-nucleoside reverse transcriptase inhibitors[J].Int J Antimicrob Agents,2019,53(4):515-519.
[1] 王小龙, 张梦寒, 朱莉勤, 邹文燕. 苏州市阪崎肠杆菌污染状况调查[J]. 预防医学, 2021, 33(4): 414-417.
[2] 纪律, 刘晓俊, 余云芳, 余枫华, 周攀. 宜昌市耐药结核分枝杆菌MIRU-VNTR分子特征及耐药基因突变分析[J]. 预防医学, 2021, 33(2): 149-152.
[3] 王云霞, 王甜甜, 张娟娟, 陈帆, 龚言红, 曹世义, 卢祖洵, 袁青. 宝安区老年肺结核患者异烟肼和利福平耐药的影响因素分析[J]. 预防医学, 2021, 33(1): 69-71.
[4] 朱业蕾, 潘爱珍, 周琳, 柳正卫, 张明五, 吴坤阳, 王晓萌, 吴蓓蓓. 浙江省非结核分枝杆菌流行状况及耐药性分析[J]. 预防医学, 2021, 33(1): 6-10.
[5] 周绍英, 张琰, 杨元斌, 高红. 宁波市食源性腹泻病例沙门菌感染分析[J]. 预防医学, 2020, 32(9): 904-906.
[6] 吴跃进, 林冠凯, 章乐怡, 李毅, 楼辉煌, 洪程基, 王良怀, 谢爱蓉, 胡玉琴. 温州市禽肉中空肠弯曲菌检测结果及耐药性分析[J]. 预防医学, 2020, 32(7): 686-688.
[7] 阙凤霞, 钟海明, 蔡光, 刘春甫, 宋灿磊, 叶玉龙. ICU环境分离肺炎克雷伯菌分子分型及耐药性分析[J]. 预防医学, 2020, 32(4): 388-391.
[8] 方芳, 赵丽丽, 徐庆嵩, 宋冰. 呼吸科住院病例医院感染病原菌分布及耐药性分析[J]. 预防医学, 2020, 32(4): 369-372.
[9] 高华强, 卢巧玲, 金法祥, 孟海滨, 孙佳美, 许树红. 绍兴市肺结核患者耐药特征分析[J]. 预防医学, 2020, 32(4): 384-387.
[10] 赵晨飞, 朱明利, 师金川, 喻剑华. 艾滋病抗病毒治疗对HIV-1感染者肠道微生态的影响[J]. 预防医学, 2020, 32(3): 274-278.
[11] 朱光平, 薛晨晨, 范宏亮, 吴南翔. 环境中抗生素抗性基因研究进展[J]. 预防医学, 2020, 32(11): 1121-1125.
[12] 阮尉月清, 刘家法, 张米, 李健健, 杨壁珲, 邓雪媚, 董兴齐. 云南省男男性行为人群HIV/AIDS病例抗病毒治疗失败基因型耐药分析[J]. 预防医学, 2020, 32(10): 987-991.
[13] 胡玉琴, 章乐怡, 李毅, 谢爱蓉, 楼辉煌, 张彬. 温州市沙门菌血清型、耐药性和PFGE指纹图谱研究[J]. 预防医学, 2019, 31(6): 640-642.
[14] 王荣, 杨晨, 丁松宁, 苗瑞芬, 李晨. 南京市复治涂阳肺结核患者耐药状况分析[J]. 预防医学, 2019, 31(5): 478-481.
[15] 罗学辉, 黄邵军, 张建群, 杨元斌. 余姚市鼠伤寒沙门菌耐药性分析[J]. 预防医学, 2019, 31(5): 484-487.
Viewed
Full text


Abstract

Cited

  Shared   
  Discussed