河北省治疗前人群HIV-1耐药毒株分子传播网络研究

目的 了解河北省抗病毒治疗前人群HIV-1耐药毒株流行与分子传播网络情况。方法 用in-house的方法扩增HIV-1 pol区基因序列,并利用TN93模型计算pol序列基因距离,构建HIV-1分子网络图。结果 研究发现17名HIV-1感染者出现耐药突变,耐药突变率为6.16%(17/276),其中,NNRTI类耐药率为4.35%(12/276),PI类耐药率为1.09%(3/276), NRTI类耐药率为0.36%(1/276),NNRTI类和PI类双重耐药率为0.36%(1/276);多因素Logistic回归分析显示年龄和亚型是HIV-1产生耐药的影响因素,虽然HIV-1耐药突变在CRF07_BC(2.44%)亚型中的分布明显低于CRF01_AE(8.03%)和B(3.70%)亚型,然而CRF07_BC序列构建的分子传播网络最多,传播速度最快。结论 河北省治疗前HIV-1耐药突变处于较高水平, 应制定措施实时监测未治疗人群中HIV-1耐药毒株流行情况。

Molecular transmission of HIV-1 resistant strains among HIV-1 individuals before antiretroviral therapy in the Hebei Province

To investigate the epidemic trend of HIV-1 resistant strains among HIV-1 individuals before antiretroviral therapy in Hebei Province. HIV-1 pol gene was amplified and sequenced using in-house method. Then, HIV-1 molecular transmission network was constructed and gene distance was calculated using TN93 model. The results indicated that a total of 17 HIV-1-infected individuals occurred drug resistance mutations, with the overall resistant rate of 6.16% (17/276). The resistant rate of NNRTI was 4.35% (12/276), followed by PI (1.09%, 3/276), NRTI (0.36%, 1/276), and NNRTI and PI (0.36%, 1/276). Multivariate Logistic regression analysis revealed that age and subtype were the effecting factors for HIV-1 drug resistance mutations. Although the resistant rate of HIV-1 in CRF07_BC (2.44%) was significant lower than CRF01_AE (8.03%) and B (3.70%), more molecular transmission networks were found in HIV-1 CRF07_BC strains. In conclusion, the resistant rate of HIV-1 before treatment in Hebei Province was relatively high, and HIV-1 drug resistance should be timely monitored.