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目的了解2015年中国部分地区新报告的16~25岁艾滋病病毒(HIV)感染者毒株的基因特征及耐药株传播情况。方法根据世界卫生组织(WHO)耐药传播监测调查方案,2015年收集了来自中国14个省市16~25岁的HIV-1感染者的血浆样本,提取病毒核糖核酸(RNA),扩增HIV-1 pol区片段并进行序列测定和亚型分析,使用美国斯坦福CPRV 6.0进行耐药突变分析。结果获得序列894条,HIV毒株亚型中CRF01_AE占39.9%、CRF07_BC占42.6%、B占4.3%、CRF08_BC占2.1%、CRF55_01B占2.9%、CRF59_01B占0.6%、CRF67_01B占0.7%、CRF68_01B占0.6%,其他重组亚型占6.4%。耐药传播率为3.6%,其中经同性性传播的耐药率为3.0%,异性性传播的为5.8%;包含针对核苷类反转录酶抑制剂(NRTI)、非核苷类反转录酶抑制剂(NNRTI)和蛋白酶抑制剂(PI)的耐药突变样本分别有10例、9例和13例。NRTI的耐药株中发现有4例携带针对替诺福韦(TDF)耐药的位点。结论当前流行毒株主要为CRF01_AE和CRF07_BC,同时在多个省份发现CRF55_01B和CRF59_01B新型重组毒株。在反转录酶和蛋白酶区均发现了主要耐药位点,而且针对TDF耐药的新型重组的传播性耐药株已在中国出现,需引起高度重视。
Objective To understand the genetic characteristics and spread of drug-resistant strains of HIV-infected persons aged 16-25 years newly reported in some parts of China in 2015. Methods According to the World Health Organization (WHO) Drug Resistant Transmission Surveillance Survey, in 2015, plasma samples from 16-25-year-old HIV-1 infected individuals in 14 provinces and cities in China were collected to extract viral RNA and amplify HIV -1 pol fragment and sequenced and subtype analysis, the use of the United States Stanford CPRV 6.0 resistance mutation analysis. Results The sequences of 894 HIV-1 strains were 39.9% for CRF01_AE, 42.6% for CRF07_BC, 4.3% for B, 2.1% for CRF08_BC, 2.9% for CRF55_01B, 0.6% for CRF59_01B, 0.7% for CRF67_01B and 0.6% for CRF68_01B %, Other recombinant subtypes accounted for 6.4%. The rate of drug-resistant transmission was 3.6%, of which resistance to homosexual transmission was 3.0% and that to heterosexual transmission was 5.8%; resistance to nucleoside reverse transcriptase inhibitors (NRTIs), non-nucleoside reverse transcripts Enzyme inhibitor (NNRTI) and protease inhibitor (PI) drug-resistant mutation samples were 10 cases, 9 cases and 13 cases. Four of the resistant strains to NRTI were found to carry sites resistant to tenofovir (TDF). Conclusions Currently, the predominant strains are CRF01_AE and CRF07_BC. At the same time, new CRF55_01B and CRF59_01B recombinant strains were found in several provinces. In the reverse transcriptase and protease regions were found in the major resistance sites, and for TDF resistant new recombinant transmissible drug-resistant strains have emerged in China, the need for high priority.