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目的 :了解江苏省艾滋病新近感染者在开展艾滋病抗病毒治疗以来HIV-1耐药株的传播水平及亚型分布情况。方法:采用WHO的截断序贯抽样法,连续3年在江苏省部分地区采集16~25岁HIV-1新近感染者的血样本各65、66和49例,提取病毒RNA,采用RT-PCR和巢式PCR扩增HIV-1pol区片段并测定pol区编码蛋白酶和逆转录酶基因的序列,提交到斯坦福大学HIV在线耐药数据库中鉴定耐药位点。用MEGA4.0软件构建进化树,分析亚型。结果:根据采样时间对样本排序,2009—2010年前47例未检出耐药样本数,2011年第28个序列出现1例耐药传播相关的耐药突变,后续一直到第44例均未有耐药样本出现,按传播水平判别表,属HIV耐药株的低度传播水平,采集的样本按pol区分型,2009、2010、2011年调查对象成功获得序列的前47例(2011年为44例)的亚型结果看,亚型以CRF01_AE为主,分别占40.40%、46.80%和56.80%,其次为CRF07_BC,分别为29.80%、25.50%、27.30%,其余还有CRF08_BC、C、B、URFA/B。结论:2009—2011年江苏省HIV-1新近感染者中HIV-1耐药株传播水平属低度,主要亚型流行情况与2006年本省调查结果类似,但与2003年前调查的HIV-1流行亚型比还是发生了显著变化。
Objective: To understand the transmission level and subtype distribution of HIV-1 resistant strains in newly infected AIDS patients in Jiangsu Province since the initiation of AIDS antiviral therapy. Methods: According to the truncated sequential sampling method of WHO, 65, 66 and 49 blood samples were collected from newly infected HIV-1 patients 16 to 25 years old in some areas of Jiangsu Province for three consecutive years. The viral RNA was extracted and analyzed by RT-PCR and The HIV-1 pol fragment was amplified by nested PCR and sequenced for the sequence encoding the protease and reverse transcriptase genes in the pol region, which was submitted to Stanford University for identification of drug-resistant sites in the HIV online drug resistance database. Phylogenetic trees were constructed using MEGA 4.0 software to analyze subtypes. Results: According to the sampling time, the sample was sequenced, the number of drug-resistant cases was not detected in 47 cases before 2009-2010, and one case of drug-resistance-related drug-resistant mutations appeared in the 28th sequence in 2011. The follow-up to the 44th case Resistant samples appeared, according to the level of transmission discrimination table, is a low level of transmission of HIV-resistant strains of the sample collected by pol-type, 2009, 2010, 2011 survey successfully obtained the first 47 cases of sequence (2011 44 cases), the subtypes were mainly CRF01_AE, accounting for 40.40%, 46.80% and 56.80%, followed by CRF07_BC, which were 29.80%, 25.50% and 27.30% respectively. The rest were CRF08_BC, C and B , URFA / B. CONCLUSIONS: HIV-1 resistant strains among HIV-1 newly infected persons in Jiangsu province between 2009 and 2011 have a low level of transmission and the prevalence of major subtypes is similar to that of the province in 2006. However, HIV-1 The prevalence of subtypes has changed significantly.