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吴昊, 高凯, 张亚丽, 徐慧芳, 蔡衍珊, 韩志刚, 梁彩云, 黎庆梅, 王鸣. 广州市孕产妇人群HIV-1亚型分布和耐药特征分析[J]. 疾病监测, 2018, 33(11): 913-918. DOI: 10.3784/j.issn.1003-9961.2018.11.008
引用本文: 吴昊, 高凯, 张亚丽, 徐慧芳, 蔡衍珊, 韩志刚, 梁彩云, 黎庆梅, 王鸣. 广州市孕产妇人群HIV-1亚型分布和耐药特征分析[J]. 疾病监测, 2018, 33(11): 913-918. DOI: 10.3784/j.issn.1003-9961.2018.11.008
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Hao Wu, Kai Gao, Yali Zhang, Huifang Xu, Yanshan Cai, Zhigang Han, Caiyun Liang, Qingmei Li, Ming Wang. Subtype distribution and drug resistance of HIV-1 in HIV infected pregnant women in Guangzhou[J]. Disease Surveillance, 2018, 33(11): 913-918. DOI: 10.3784/j.issn.1003-9961.2018.11.008
Citation: Hao Wu, Kai Gao, Yali Zhang, Huifang Xu, Yanshan Cai, Zhigang Han, Caiyun Liang, Qingmei Li, Ming Wang. Subtype distribution and drug resistance of HIV-1 in HIV infected pregnant women in Guangzhou[J]. Disease Surveillance, 2018, 33(11): 913-918. DOI: 10.3784/j.issn.1003-9961.2018.11.008
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广州市孕产妇人群HIV-1亚型分布和耐药特征分析

Subtype distribution and drug resistance of HIV-1 in HIV infected pregnant women in Guangzhou

    摘要
  • 摘要:
    目的 了解广州市孕产妇人群艾滋病病毒1型（HIV-1）亚型和耐药情况。
    方法 收集广州市2009 — 2014年孕产妇人群HIV-1抗体阳性样本，扩增蛋白酶（PR）和反转录酶（RT）基因序列，测序后构建系统进化树确定亚型，并与斯坦福大学HIV耐药数据库比对进行耐药分析。
    结果 成功获得178份基因片段，其中10份为外籍病例；中国籍病例以CRF01_AE ［42.86%（72/168）］ 和CRF07_BC ［31.55%（53/168）］为主，外籍病例以C和CRF01_AE为主，各占30.00%（3/10）。 中、外籍病例的亚型分布差异有统计学意义（P＜0.001）。 样本总体耐药突变率为12.36%（22/178），低度以上耐药率为5.62%（10/178），蛋白酶抑制剂（PIs）、核苷酸反转录酶抑制剂（NRTIs）和非核苷酸反转录酶抑制剂（NNRTIs）耐药率分别为2.81%（5/178）、1.12%（2/178）和2.25%（4/178）。 耐药突变率最高的亚型为C亚型［50.00%（3/6）］。 5例外籍病例携带耐药突变，其中3例为耐药病例。 3.37%（6/178）样本被预测对单类药物呈高度耐药，未发现对多类药物呈高度耐药的样本。
    结论 广州市HIV感染的孕产妇人群中有12种病毒亚型，以CRF01_AE和CRF07_BC为主，耐药突变率及耐药率低，但存在PIs或NRTIs或NNRTIs的高度耐药毒株且外籍病例具有较高耐药突变率和耐药率。

     

    Abstract:
    Objective To understand the subtype distribution and drug resistance of HIV-1 in HIV infected pregnant women in Guangzhou of Guangdong province.
    Methods Plasma samples from pregnant women who were positive for HIV-1 were collected during 2009–2014 for the amplification of protease (PR) and reverse transcriptase (RT) gene segments with nested reverse transcription polymerase chain reaction (nested-PCR). HIV subtypes were determined through phylogenetic analysis and the drug resistance mutation (DRM) was analyzed with HIV Drug Resistance Database of Stanford University.
    Results A total of 178 gene segments, including 10 from foreign cases, were successfully amplified. Significant difference in subtype distribution was observed between domestic cases and foreign cases (P＜0.001), the predominant subtypes were CRF01_AE (42.86%, 72/168) and CRF07_BC (31.55%, 53/168) in domestic cases and the predominant subtypes were C (30.00%, 3/10) and CRF01_AE (30.00%, 3/10) in foreign cases. The incidence rate of DRM was 12.36%.The upper low level resistant rates to any drug was 5.62% (10/178), and the resistant rates to protease inhibitors (PIs), nucleoside reverse transcriptase inhibitors (NRTIs), non-nucleoside reverse transcriptase inhibitors (NNRTIs) were 2.81% (5/178), 1.12% (2/178) and 2.25% (4/178), respectively. Subtype C showed the highest DRM rate (50.00%, 3/6). DRMs were observed in 5 foreign cases and 3 cases were drug resistant. Six samples (3.37%) were predicted to be highly resistant to single class drug. No samples which were highly resistant to multi-class drugs were detected.
    Conclusion Twelve HIV-1 subtypes were detected in HIV infected pregnant women in Guangzhou, the predominant subtypes were CRF01_AE and CRF07_BC. The DRM rate and drug resistant rate were low, but the strains with high resistance to PIs or NRTIs or NNRTIs were observed and the foreign cases had higher DRM rate and drug resistant rate.

     

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