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目的调查了解2012年云南省艾滋病高流行区文山州未经抗病毒治疗的HIV感染者的基因型分布和耐药株传播水平。方法根据HIV耐药警戒线调查实施方案,对2012年1月~12月文山州符合要求的68份年龄在16~25岁新发现的HIV-1感染者的血浆样本进行HIV-1耐药基因型检测和耐药株传播水平分析。结果 45份完成了基因型及耐药鉴定。通过进化分析对pol区进行分型,48.9%的样本为CRF08_BC,其他依次为:CRF01_AE(42.2%)和CRF07_BC(8.9%)。获得的序列中未检测到监测相关的耐药突变(surveillance drug resistance mutations,SDRM),按照耐药警戒线的统计方法估算耐药株流行率小于5%。结论本次调查的样本中主要的HIV-1基因型为CRF08_BC及CRF01_AE,文山州目前HIV-1耐药株处于低度流行水平。为控制耐药传播水平的上升,在加强重点人群艾滋病防治的基础上,应加强规范艾滋病抗病毒治疗及科学管理,同时有计划地开展相关的耐药监测。
Objective To investigate the genotype distribution and drug-resistant transmission of uninfected HIV-infected patients in Wenshan Prefecture in Yunnan Province in 2012. Methods HIV-1 resistance gene was tested in 68 newly diagnosed HIV-1-infected plasma samples from 16 to 25 years old in Wenshan Prefecture from January to December in 2012 according to the implementation plan of HIV resistance alert line survey. Type detection and transmission of drug resistant strains. Results 45 completed the genotype and drug resistance identification. The pol region was genotyped by evolutionary analysis, 48.9% of the samples were CRF08_BC and the others were: CRF01_AE (42.2%) and CRF07_BC (8.9%). No detectable drug resistance mutations (SDRM) were detected in the obtained sequences, and the prevalence of drug-resistant strains was estimated to be less than 5% according to the statistical method of drug resistance warning. Conclusion The main genotypes of HIV-1 in this survey were CRF08_BC and CRF01_AE, and HIV-1 resistant strains in Wenshan Prefecture are currently at low prevalence levels. In order to control the rise of drug-resistant transmission, on the basis of strengthening AIDS prevention and treatment of key populations, we should step up the regulation of AIDS anti-virus treatment and scientific management, and carry out related drug resistance surveillance in a planned manner.