南宁市静脉注射吸毒人群HIV-1基因亚型及耐药性分析

目的了解南宁市静脉注射吸毒人群(IDUs)中HIV-1流行基因亚型及其耐药性,为辖区艾滋病防治策略制定提供科学依据。方法收集2017年南宁市静脉注射吸毒人员HIV感染者血浆样本总共68份,提取病毒核糖核酸(RNA),通过巢式PCR对HIV pol基因片段进行扩增测序,构建系统进化树进行基因分型,并将序列提交至美国斯坦福大学HIV耐药数据库分析,利用pol基因测序结果分析HIV-1亚型和耐药性情况。结果 68份血浆样本中巢式PCR成功扩增基因片段62份,系统进化分析显示检出3种HIV-1重组基因亚型,CRF_01-AE亚型占72.6%(45/62)、CRF_07-BC亚型占12.9%(8/62)、CRF_08-BC亚型占14.5%(9/62),CRF01_AE型为主要流行亚型。χ~2检验分析显示在性别、年龄、民族、婚姻4个人口学特征中62份样本HIV-1亚型组成差异无统计学意义(P>0.05)。62份样本中3例CRF_08-BC亚型发现T69S耐药突变,1例CRF_01-AE亚型发现L210W突变,1例CRF_07-BC亚型发现A71V突变。结论南宁市IDUs人群HIV-1感染者中至少存在3种HIV-1基因亚型流行,CRF_01-AE重组型为优势流行株,研究中出现的耐药突变位点为低度耐药突变位点,应密切监视其流行趋势。

HIV-1 genotypes and drug resistance among intravenous drug users in Nanning

Objective To investigate the prevalence of HIV-1 subtypes and drug resistance among intravenous drug users in Nanning, and to provide scientific basis for the formulation of the current district AIDS prevention strategies. Methods HIV-1 serums were collected from 68 intravenous drug users in Nanning during 2017, virus ribonucleic acid (RNA) was extracted, HIV-1 pol gene was amplified by Nested-PCR and then the DNA was sequenced and analyzed by phylogenetic tree to determine HIV-1 genotyping. The sequences were submitted to Stanford university HIV resistant database to compare. HIV-1 subtypes and drug resistance were determined by using pol gene sequencing results. Results A total of 62 fragments were successfully amplified from 68 serum samples, phylogenetic analysis demonstrated that three circulating recombinant forms (CRF) subtypes were confirmed, including 45 cases of CRF01_AE (72.6%), 8 cases of CRF07_BC (12.9%), 9 cases of CRF08_BC (14.5%). Chi-square test showed that there was no significant difference among 62 samples of HIV-1 gene subtype distribution in gender, age, ethnic and married status (P>0.05). For 62 fragments, T69S resistant mutation found in 3 cases of CRF_08-BC, L210W resistant mutation found in 1 case of CRF_01-AE and A71V resistant mutation found in 1 case of CRF_07-BC. Conclusions There are at least three HIV-1 circulating recombinant forms (CRF) subtypes among intravenous drug users in Nanning, CRF_01-AE circulating recombinant forms is the most epidemic strains. All drug resistance mutation sites found in this study are low resistance site. The epidemic trend should be closely monitored.