温州市新报告HIV-1感染者治疗前耐药分析

doi:10.19485/j.cnki.issn2096-5087.2021.05.004

预防医学

2021, Vol. 33

Issue (5): 446-450 DOI: 10.19485/j.cnki.issn2096-5087.2021.05.004

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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

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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。

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	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

Abstract：Objective 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 words： human immunodeficiency virus type 1 antiretroviral therapy drug resistance gene sequence

收稿日期: 2020-12-30 修回日期: 2021-02-08 出版日期: 2021-05-10

中图分类号:

R512.91

基金资助:温州市科技局项目（Y2020554,Y2020542）

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

通信作者: 张佳峰,E-mail：jfzhang@cdc.zj.com

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.

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https://www.zjyfyxzz.com/CN/10.19485/j.cnki.issn2096-5087.2021.05.004 或 https://www.zjyfyxzz.com/CN/Y2021/V33/I5/446

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