2015年江苏省HIV耐药警戒线调查

发布时间：2018-04-23 22:29

本文选题：HIV- + HIV亚型　；参考：《南京医科大学学报(自然科学版)》2017年02期

【摘要】：目的:了解2015年江苏省的免疫缺陷病毒(HIV)耐药株传播水平和亚型分布。方法:采用WHO的截断序贯抽样法,在江苏省获得性免疫缺陷综合征(艾滋病)疫情主要发生地南京采集47例当年新报告25岁以下HIV感染者血样,提取病毒RNA,采用RT-PCR和巢式PCR扩增HIV-1 pol区片段,并进行传播型耐药基因型分析。结果:2015年调查对象的序列成功获得率为100%(47/47),亚型以CRF01_AE亚型为主(59.6%),其次依次为CRF07_BC(25.5%)、C亚型(6.4%例)和B亚型(2.1%),并在亚型分析中发现3例URFs。江苏省HIV耐药传播水平为低流行,47份样本中发现1份样本存在传播型耐药位点突变,为蛋白酶区耐药位点突变(M46I)。该例耐药个体感染途径为同性传播,亚型为CRF01_AE。此次抽样调查发现学生所占比例最大,为46.8%(22/47),已超过商业服务人员29.8%(14/47)的比例。传播途径除1例异性传播外,其余均为同性传播。结论:江苏省首次发现传播型耐药1例,说明耐药株已开始传播。虽仍为低流行,但应密切关注耐药株传播水平的趋势变化。学生逐渐成为25岁以下感染者的主要群体,扩大对该人群的检测咨询干预工作应成为艾滋病防控工作的重点。对男男性行为做好预防措施,是控制耐药株传播的关键。
[Abstract]:Objective: to investigate the transmission level and subtype distribution of HIV-resistant strains in Jiangsu Province in 2015. Methods: using the truncated sequential sampling method of WHO, 47 blood samples of HIV infected persons under 25 years old were collected in Nanjing, the main place of the acquired immunodeficiency syndrome (AIDS) epidemic in Jiangsu Province. RT-PCR and nested PCR were used to amplify the HIV-1 pol region, and the genotypes of transmissible drug resistance were analyzed. Results: the success rate of the subjects in 2015 was 100 / 47 / 47. The subtypes of CRF01_AE were 59.6%, followed by CRF07BC25.5G (6.4%) and B subtype (2.1%). Three cases of URFs were found in the subtype analysis. In Jiangsu Province, the level of HIV resistance transmission was low prevalence. One of 47 samples was found to have a mutation of resistance locus of transmission type, which was M46IH4, a mutation of resistance locus in protease region. In this case, the route of infection is the same sex transmission, and the subtype is CRF 01 AE. The sample survey found that the proportion of students was the largest, at 46.822 / 47, which was higher than that of business service personnel (29.814 / 47). With the exception of one case of heterosexual transmission, the other means of transmission were same-sex transmission. Conclusion: one case of transmissible drug resistance was first found in Jiangsu Province, indicating that the resistant strain had begun to spread. Although it is still low prevalence, we should pay close attention to the trend of transmission level of resistant strains. Students have gradually become the main group of infected people under 25 years old. It should be the focus of AIDS prevention and control work to expand the testing and counseling of this population. Prevention of male behavior is the key to control the transmission of resistant strains.
【作者单位】：江苏省疾病预防控制中心性病艾滋病防制所;南京农业大学农学院;
【基金】：国家自然科学基金(81373125)
【分类号】：R512.91

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