深圳市龙岗区新确证HIV/AIDS病例的亚型分布及耐药分析

目的 了解深圳市龙岗区新增确证艾滋病病毒感染者（HIV）/艾滋病病人（AIDS）的流行病学特征、HIV-1亚型分布及耐药株流行状况，为当地的艾滋病防控提供参考依据。方法 对深圳市龙岗区2016—2019年新报告HIV/AIDS病例开展流行病学横断面研究，按年分层随机抽取432例HIV/AIDS患者血清并提取病毒RNA，一步法逆转录PCR和巢式PCR法扩增HIV-1 pol区基因并测序，以邻接法（Neighbor-Joining method, NJ）构建系统进化树鉴定亚型，通过美国斯坦福大学HIV耐药数据库进行耐药分析。结果 研究对象1 519例中男性占比最高（88.61%,1 346/1 519），广东省以外户籍居多（66.16%,1 005/1 519），同性传播比例多于异性传播，54.58%(829/1 519)新增病例的CD4+T淋巴细胞≥350个/μL。成功获得368份pol基因序列，共发现11种HIV-1基因亚型及17例独特重组型（URF），优势亚型为CRF01＿AE和CRF07＿BC，其他包括CRF55＿01B、B亚型、CRF08＿BC、CRF 59＿01B,C亚型、G亚...

Genotype distribution and transmitted drug resistance analysis of newly-diagnosed HIV/AIDS patients in Longgang district of Shenzhen

Objective This study aim to realize the epidemiological characteristics, genotype distribution of HIV-1 and epidemic situation of drug resistance in newly-reported HIV infections in Longgang district of Shenzhen. It provides a reference for the overall prevention and control of AIDS in the local area. Methods A cross-sectional study of epidemiology was proceeded on newly-identified HIV/AIDS infections in Longgang district, Shenzhen during 2016-2019. 432 plasma samples were collected by random sampling, and its RNA were extracted. The pol fragment of HIV-1 genome was amplified by one-step RT-PCR and nested-PCR and was sequenced. Subtype analysis was performed by phylogenetic tree with neighbor-joining method. The HIV resistance mutations were determined with the use of Stanford University HIV Drug Resistance Database. Results Subjects were majority males (88.61%, 1 346/1 519)and migrants（66.16%,1 005/1 519）, and the proportion of HIV infections through Homosexual behavior were higher in infected mainly through heterosexual behavior. The CD4⁺ T lymphocyte counts of HIV patients were 54.58% (829/1 519) above 350 cells/μL. 368 segments were successfully amplified, among which 11 genotypes of HIV-1 and 17 URF strains were found. The main subtypes were CRF01_AE and CRF07_BC, others were CRF55_01B, B, CRF08_BC, CRF 59_01B, C, G, CRF 67_01B, CRF79_0107 and CRF 68_01B. 33 transmission clusters were found, with the total clustered rate of 21.47% (79/368). CRF55_01B had the highest cluster rate (44.90%, 22/49), which was higher than the major subtypes CRF01_AE and CRF07_BC. The drug resistance mutations of WHO recommendation were found in fourteen samples. The overall rate of transmitted drug resistance (TDR) was 3.80%. TDR was predominantly towards NNRTIs, and the subtype CRF01_AE showed the highest drug resistance mutation rate. Conclusions The distribution of HIV-1 subtypes of newly reported HIV/AIDS in Longgang district of Shenzhen is complex and diverse, and the overall drug resistance rate remain at a low level. The clustering transmission of HIV-infection of CRF55_01B has been established, so the targeted intervention of this population needs to be strengthened.