浦东新区MSM HIV-1分子流行病学的研究

发布时间：2018-04-25 23:01

本文选题：艾滋病病毒型 + 基因亚型　；参考：《中国艾滋病性病》2015年06期

【摘要】：目的了解上海市浦东新区近年来男男性行为人群(MSM)中,未经抗病毒治疗的艾滋病病毒1型(HIV-1)抗体阳性者,其HIV-1亚型分布和原发性耐药特征,监测该地区MSM HIV-1毒株的最新流行情况,为当前该区制定艾滋病防治策略提供科学依据。方法选取2011年至2014年4月份期间确认的MSM HIV-1感染者血浆标本70份,应用巢式反转录聚合酶链反应(RT-PCR)扩增pol基因,并对扩增产物进行测序,用Mega 6.0软件将测序结果与各亚型国际参考株比对,根据系统进化树分析确定基因亚型及其特征以及耐药情况。结果获62份pol区基因全序列片段,得到CRF01-AE、CRF07_BC、01B(CRF01_AE与B重组亚型)和B四种亚型。分布显示:CRF01-AE占58.06%(36/62),CRF07_BC占30.65%(19/62),01B占6.45%(4/62),B占4.84%(3/62)。离散率显示:CRF01-AE亚型的平均离散率为(2.1±0.2)%(n=36),CRF07-BC亚型的平均离散率也为(2.1±0.2)%(n=19),B亚型的平均离散率为(5.7±0.6)%(n=3),01B重组亚型的平均离散率为(6.3±.0.6)%(n=4)。耐药特征:62例中有7例分别产生了对核苷类反转录酶抑制剂(NRTIs)、非核苷类反转录酶抑制剂(NNRTIs)及蛋白酶类抑制剂(PIs)的耐药突变,其中2例产生了低度耐药,4例具有潜在的耐药特点。结论上海市浦东新区2011年至2014年4月间,MSM新确证HIV-1感染者中,基因亚型呈多元化趋势,以CRF01-AE和CRF07-BC为主,并已形成了浦东新区范围内的局部流行趋势,新的01B重组毒株已在浦东新区开始出现;HIV-1原发耐药株的传播尚处于低度流行水平,密切监视其流行趋势已显十分必要。
[Abstract]:Objective to investigate the distribution of HIV-1 subtypes and the characteristics of primary drug resistance in MSM of men who had sex with men in Pudong New District of Shanghai in recent years. To monitor the latest epidemic situation of MSM HIV-1 strains in this area and provide scientific basis for the current HIV / AIDS prevention and control strategy in this area. Methods 70 plasma samples of MSM HIV-1 infected patients from 2011 to 2014 were selected. Nested reverse transcriptase polymerase chain reaction (RT-PCR) was used to amplify the pol gene, and the amplified products were sequenced. Mega 6.0 software was used to compare the sequencing results with the international reference strains of each subtype. According to phylogenetic tree analysis, the gene subtypes, their characteristics and drug resistance were determined. Results 62 full-sequence fragments of pol gene were obtained, and four subtypes of CRF01-AEEEF07C / BC01B / CRF01AE and B recombination subtypes were obtained. The distribution shows that 58.06% of the total number is 36 / 622 / 622 / 60.65 / 19 / 622 / 01B / 6.4545 / 62mb / 4.84 / 62 / 62respectively. The average dispersion rate of the subtype 1: CRF01-AE is 2.1 卤0.2%. The average dispersion rate of the subtype CRF07-BC is 2.1 卤0.2%. The average dispersion rate of the subtype B is 5.7 卤0.6. The average dispersion rate of the recombination subtype 01B is 6.3 卤.0.61.The average dispersion rate of the subtype of CRF01-AE is 2.1 卤0.2and the average dispersion rate of the subtype B is 5.7 卤0.61.The average dispersion rate of the recombination subtype is 6.3 卤.0.6. Among 62 cases of drug resistance, 7 cases had mutagenesis to nucleoside reverse transcriptase inhibitor (NRT Isa), non nucleoside reverse transcriptase inhibitor (NNRT Isa) and protease inhibitor (PIsa). Among them, 2 cases had low resistance and 4 cases had potential drug resistance. Conclusion the gene subtypes of newly confirmed HIV-1 infections in Pudong New area of Shanghai from 2011 to April 2014 showed a trend of diversity, mainly CRF01-AE and CRF07-BC, and had formed a local epidemic trend in Pudong New area. The transmission of the new recombinant strain 01B has begun to appear in Pudong New area, and the transmission of HIV-1 primary drug resistant strain is still at a low epidemic level. It is necessary to monitor the epidemic trend closely.
【作者单位】：上海市浦东新区疾病预防控制中心;上海市疾病预防控制中心;
【基金】：国家“十二五”艾滋病和病毒性肝炎等重大传染病防治重大科技专项(2012ZX10004201)~~
【分类号】：R512.91

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