首页|吉林省HIV-1感染者治疗前耐药和分子传播网络特征分析

吉林省HIV-1感染者治疗前耐药和分子传播网络特征分析

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目的 了解吉林省HIV-1(human immunodeficiency virus-1,HIV-1)感染者治疗前基因型耐药及分子网络传播情况.方法 选取2022年治疗前HIV感染者228名,提取血浆RNA、反转录PCR扩增HIV-1 pol基因片段.建立进化树确定亚型、解析基因型耐药突变(drug resistance mutations,DRMs)情况并构建HIV分子网络评估传播关系.结果 从228例样本中成功获得206条pol基因序列,基因亚型主要为CRF01_AE(60.68%,125/206)、CRF07_BC(30.10%,62/206)和B亚型(5.34%,11/206).总耐药率为9.22%(19/206),耐药突变以非核苷逆转录酶抑制剂为主,占8.25%(17/206).多因素logistic回归分析表明,40-49岁和≥50岁,离异或丧偶感染人群产生耐药的风险较高(P<0.05).白城地区和CRF07_BC感染者入网风险更大(P<0.05).有63条序列入网(30.58%,63/206),形成23个分子簇.入网病例中6例携带DRMs.出现本市和跨市连接边关系.异性与同性性传播感染人群存在混合连接边.结论 吉林省HIV感染者治疗前耐药率处于中等水平,分子网络中的毒株呈地区聚集性,加强耐药监测,对网络桥梁人群进行有针对性的干预措施,减少治疗前发生耐药传播的可能性.
Characteristics of drug-resistance and molecular transmission network among pre-treatment HIV-1 infected patients in Jilin province
Objective To understand the characteristics of drug resistance and molecular network transmission among pre-treatment human immunodeficiency virus-1(HIV-1)infected patients in Jilin province.Methods Two hundred and twenty-eight pre-treatment HIV infected patients in 2022 were recruited.Plasma RNA was extracted and pol gene fragment was amplified by reverse transcription-polymerase chain reaction(RT-PCR).The phylogenetic tree was reconstructed for subtype determination,drug-resistance mutations(DRMs)analysis.The molecular networks were constructed to evaluate the transmission relationship.Results Two hundred and six sequences were obtained successfully from the 228 samples.The main subtypes were CRF01_AE(60.68%,125/206),CRF07_BC(30.10%,62/206)and B(5.34%,11/206).The overall drug-resistance rate was 9.22%(19/206),and the DRMs were mainly associated with from non-nucleoside reverse transcriptase inhibitors(NNRTIs),accounting for 8.25%(17/206).Multivariable logistic regression analysis showed that the risk of drug resistance were higher in groups of 40-49 years old,≥50 years old and divorced or widowed individuals(P<0.05).The infected people in Baicheng city and patients with CRF07_BC infection were more likely to access the network(P<0.05).There were 63 sequences enrolled in the network and formed 23 molecular clusters(30.58%,63/206).Among the cases in the network,6 cases carried DRMs.There existed the"intra-city"and"inter-city"connection relationships and a mixing junction between heterosexual and homosexual transmission groups.Conclusions The drug resistance rate of pre-treatment HIV infected patients was at moderate level,and the virus strains clustered by geographical regions.The surveillance of drug resistance should be enhanced.The targeted intervention measures for the bridge-population should be applied to reduce the possibility of pre-treatment drug-resistance transmission.

Human immunodeficiency virusPretreatment drug resistanceTransmitted drug resistanceMolecular network

郭琪、王岙、冯毅、吴东林、齐晓晨、王慧、臧希卉、刘思含、邢辉、孙柳燕

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吉林省疾病预防控制中心 吉林省预防医学科学院病毒检验所,长春 130062

中国疾病预防控制中心性病艾滋病预防控制中心,北京 102206

艾滋病病毒 治疗前耐药 传播性耐药 分子网络

吉林省科技计划项目

20230203021SF

2024

国际病毒学杂志
中华医学会,北京市疾病预防控制中心

国际病毒学杂志

CSTPCD北大核心
影响因子:1.826
ISSN:1673-4092
年,卷(期):2024.31(4)