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2011-2020年大连市无偿献血人群HIV-1耐药性突变分析

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目的 了解2011-2020 年大连市无偿献血人群的HIV耐药性突变的分布和传播趋势。方法 对2011-2020 年大连市无偿献血者HIV感染标本的PR-RT序列进行检测,利用The Stanford HIV Drug Resistance Database分析标本耐药性突变和耐药程度。结果 在 174 份标本中共检测出 30 份携带耐药性突变(drug resistance mutation,DRM),DRM携带率为 17。2%(30/174),传播性耐药(transmitted drug resistance,TDR)携带率为 5。7%(10/174)。研究期间,DRM和TDR携带率在 2019 年出现大幅度升高,2020 年分别达到 44。4%、22。2%,均为历史最高水平。具备大专以上学历、本地常住特征的献血者其DRM携带率显著高于其他人群(P<0。05)。标本携带NNRTI类DRM占比最高(12。6%,22/174),PI类次之(5。7%,10/174),分别以 V179D/E/T和 M46I 为主;仅 1 份(0。57%,1/174)携带NRTI类DRM(L74I)。标本整体耐药率为 6。9%(12/174),以对NNRTI类药物耐药占比最高(83。3%,10/12);2 份(1。1%,2/174)标本同时对一线推荐用药EFV和NVP高度耐药。基因型为CRF55_01B标本的DRM携带率显著高于其他基因型(P<0。05)。结论 2019-2020 年大连市无偿献血人群HIV耐药性突变携带率呈现明显上升趋势,对NNRTI类药物耐药标本占比最高。将ART实施前后的耐药性监测数据与最新版国家ART治疗方案相结合,有利于提高本地HIV防控效果。
Drug resistance mutation analysis of HIV-1 among blood donors in Dalian:2011-2020
Objective To study the distribution and trend of HIV-1 drug resistance mutation in Dalian blood donors be-tween 2011 and 2020.Methods The protease-reverse transcriptase(PR-RT)region was sequenced in Dalian blood donors tested HIV-1 positive between 2011 and 2020.Drug resistance mutation(DRM)rate and level of resistance to selected drugs were analyzed by the Stanford HIV Drug Resistance Database.Results DRM were detected in 17.2%(30/174)of samples,while transmitted drug resistance(TDR)was5.7%(10/174).Between2011 and2020,DRM and TDR rates in-creased significantly in 2019 and reached their highest levels in 2020(44.4%and 22.2%,respectively).DRM carriage was associated with people with college degree or above and with local residents(P<0.05).NNRTI DRMs were the most fre-quently detected(12.6%,22/174),followed by PIs(5.7%,10/174),with V179D/E/T and M46I being the main DRMs detected.Only one HIV-1strain(0.57%,1/174)carried a NRTI DRM(L74I).The overall rate of predicted high level re-sistance to antiretroviral drugs was 6.9%(12/174),with the highest proportion of NNRTI resistance(83.3%,10/12).Two samples were classified as highly resistant to EFV and NVP,accounting for 1.1%(2/174).CRF55_01B strains showed a significantly higher DRM rate than strains of other HIV-1 genotypes(P<0.05).Conclusion Between 2011 and 2020,the rate of HIV-1 DRMs in blood donors in Dalian showed a significant upward trend,particularly in 2019-2020,with NNRTI resistance being the most common.The combination of DRMs detection before and after implementation of ART un-der the latest national ART treatment plan would improve the effectiveness of HIV-1 prevention and control locally.

HIV-1drug resistance mutationblood donor

郭笑寒、邓雪莲、刘笑春、王颖颖、臧亮、周俊

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大连市血液中心,辽宁 大连 116001

圣湘生物科技股份有限公司

HIV 耐药性突变 无偿献血人群

大连市医学科学研究计划项目

2011038

2024

中国输血杂志
中国输血协会 中国医学科学院输血研究所

中国输血杂志

CSTPCD
影响因子:1.279
ISSN:1004-549X
年,卷(期):2024.37(8)