云南省德宏州2014年HIV-1耐药传播警戒线调查

目的 调查2014年云南省德宏州未经抗病毒治疗的HIV感染者的耐药株传播水平。方法 2014年1-8月在德宏州收集70份新报告的16~25岁HIV-1感染者的血浆样品,对符合耐药警戒线调查要求的58份样品进行HIV-1基因型耐药检测和耐药株传播水平分析。结果 50份样品完成了基因型及耐药鉴定,中国籍占34.0%,缅甸籍占66.0%。通过进化分析对pol区进行分型,主要的基因型包括CRF01_AE、C亚型、URFs、CRF62_BC、CRF08_BC、CRF07_BC、CRF64_BC、B亚型和CRF55_01B,分别占28.0%、20.0%、20.0%、10.0%、8.0%、4.0%、4.0%、4.0%和2.0%。在1个序列中检测到1个针对蛋白酶抑制剂类药物的耐药突变位点(M46I),按照耐药警戒线的统计方法估算耐药株流行率<5%。结论 德宏州16~25岁新报告的HIV-1感染人群中外籍比例较高,HIV新型重组开始传播,但HIV-1耐药性传播尚处于低度水平。

Study on the threshold of HIV-1 drug resistance in Dehong prefecture of Yunnan province in 2014

Objective To study the HIV-1 genotypes and transmitted drug resistance(TDR) in Dehong prefecture of Yunnan province in 2014.Methods A total of 70 plasma samples of recently reported HIV-infected individuals between 16 and 25 years old were collected in Dehong prefecture from January to August 2014.Among them, 58 samples which met the criterion of HIV drug resistance threshold survey(HIVDR-TS) were subjected to genetic drug resistance detection.Results 50 plasma samples were successfully sequenced and analyzed.Among them, 34.0% were Chinese and 66.0% were Burmese.Based on pol sequences, all the identified HIV genotypes would include CRF01_AE(28.0%), subtype C(20.0%), URF(20.0%), CRF62_BC(10.0%), CRF08_BC(8.0%), CRF07_BC(4.0%), CRF64_BC(4.0%), subtype B(4.0%) and CRF55_01B(2.0%).One drug, which resistant mutation to proteinase inhibitors had been detected in one sequence.Based on the statistical method of HIVDR-TS, the prevalence of transmitted HIV-1 drug resistance was adjusted as<5%.Conclusion The proportion of Burmese was relatively higher among those newly reported HIV-infected individuals aged 16 to 25 in Dehong.We noticed that the novel circulating recombinant forms began to function.However, the level of transmission through HIV-1 drug resistant strains still kept low in Dehong.