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分析宁夏地区HIV-1异性传播人群的基因亚型分布和耐药突变特征。收集2021年宁夏接受抗病毒治疗的HIV/AIDS患者的血浆样品并进行横断面调查，对病毒载量大于400拷贝/mL且感染途径为异性传播的患者进行基因型耐药检测，分析基因亚型及耐药特征。101例通过异性传播的HIV/AIDS患者中，共发现9种HIV-1亚型毒株流行，CRF07＿BC亚型和CRF01＿AE亚型为主要基因亚型。43例患者出现耐药基因突变，总体耐药率为2.10%(43/2 046)，仍处于低流行水平，以NRTIs/NNRTIs为主，NNRTIs耐药突变率高于NRTIs和PIs。PI耐药突变位点主要为M46L和Q58E;NRTI耐药突变以M184V/I/MV、K65KR/R/N、K70E/KN为主；NNRTI耐药突变以K103N/KN/S、V179D/E/T、V106M/A/I为主。NRTIs耐药者对FTC和3TC高度耐药最多均为18.81%;NNRTIs耐药者对NVP和NEFV高度耐药最多，且耐药发生率最高均为35.64%；未发现PI高度耐药。2021年宁夏异性传播人群HIV-1基因亚型多样性增加，共检出9种HIV-1基因亚型，以CRF07＿BC亚型和CRF01＿AE亚型为主，且首次检出CRF59＿01B亚型。该人群的总耐药率为2.10%，依据WHO提出的5%中度耐药警戒线，仍处于低流行水平。在耐药情况方面，以NNRTIs/NRTIs耐药为主，其中CRF01＿AE亚型耐药率最高。提示需要持续关注HIV-1基因亚型的变化，加强监测HIV-1耐药毒株的流行情况，并扩大样本量持续探讨基因亚型和耐药之间的关联性，从而有效控制耐药的发生。
Abstract：This study aims to analyze the distribution of HIV-1 genotypes and the characteristics of drug resistance mutations in heterosexual HIV-1 transmission population in Ningxia, China. Plasma samples were collected from HIV/AIDS patients receiving ART in Ningxia, China in 2021 and a cross-sectional survey was conducted. HIV-1 genotypic drug resistance testing was performed in patients who were infected by heterosexual transmission with viral load >400 copies/mL, and the characteristics of HIV genotypes and drug resistance were analyzed. Nine HIV-1 subtypes were circulated among 101 heterosexual HIV/AIDS patients, and the main gene subtypes were CRF07＿BC and CRF01＿AE. Forty-three patients had drug-resistant mutations, and the overall drug resistance rate was 2.10%, which was still at a low epidemic level, mainly with double resistance of NRTI/NNRTI. The resistant rate of NNRTI was higher than NRTI and PI. The main PI mutations were M46L and Q58E. NRTI mutations occurred mainly at M184V/I/MV, K65KR/R/N, K70E/KN. NNRTI mutations occurred mainly at K103N/KN/S, V179D/E/T, and V106M/A/I. Among the patients with NRTI resistance, 18.81% were highly resistant to FTC and 3TC. NNRTI resistant patients were most highly resistant to NVP and EFV, and the highest incidence of drug resistance was 35.64%. There was no high drug resistance to PI. In 2021, the genetic diversity was increased in the heterosexual transmission population in Ningxia, China with a total of 9 HIV-1 gene subtypes detected, mainly CRF07＿BC and CRF01＿AE subtypes, and the CRF59＿01B subtype was detected for the first time. The total drug resistance rate of this population was 2.10%, which was still at the low epidemic level according to the moderate drug resistance warning line of 5% proposed by World Health Organization. In terms of drug resistance, NNRTIs/NRTIs was the main drug resistance, and CRF01＿AE subtype had the highest drug resistance rate. It is necessary to strengthen the monitoring of HIV-1 subtypes and the prevalence of drug-resistant strains, and to expand the sample size to continuously explore the association between genotypes and drug resistance, so as to effectively control the occurrence of drug resistance.
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基本信息:
DOI：10.13242/j.cnki.bingduxuebao.004314
中图分类号:R512.91
引用信息:
[1]司冰倩,马春花,吴玉灵,等.2021年宁夏异性传播人群HIV-1基因亚型和耐药特征分析[J].病毒学报,2023,39(03):783-790.DOI:10.13242/j.cnki.bingduxuebao.004314.
基金信息:
2017年宁夏青年拔尖人才项目（项目号：宁卫计函发{2018}178号）; 2020年宁夏回国人员创新创业项目（项目号：宁人社函{2021}5号）,题目：核酸定量检测在优化艾滋病一站式早期诊断中的应用~~
2023-04-28
2023-04-28
2023-04-28