CAJ | 학술논문

目的调查2013年云南省德宏州未经抗病毒治疗的HIV-1感染者的基因型分布和耐药毒株传播水平.方法根据HIV耐药警戒线调查实施方案,对2013年1-8月德宏州符合要求的54份年龄在16 ～ 25岁,新发现的HIV-1感染者的血浆样本进行HIV-1基因型检测和耐药毒株传播水平分析.结果 48份样本完成了基因型及耐药鉴定,中国籍占45.8％,缅甸籍占54.2％.通过进化分析对pol区进行分型,主要的基因型包括:C亚型(41.7％)、URF(31.3％)、CRF01 AE(12.5％)、CRF07 BC(10.4％)、CRF08 BC(2.1％)和B亚型(2.1％).中国籍感染者中首位的基因型是C亚型,而外籍感染者中首位的基因型是URF.在1份缅甸籍样本序列中检测到1个针对非核苷类反转录酶抑制剂类药物的耐药突变位点(K103N),按照耐药警戒线的统计方法估算耐药毒株流行率为＜5％.结论本次调查提示德宏州新报告的HIV-1感染者中存在复杂的基因型,HIV-1耐药毒株处于低度流行水平.为控制耐药传播水平的上升,应进一步规范本地艾滋病抗病毒治疗及管理,并针对跨境传播开展包括耐药传播在内的相关监测.
목적 조사2013년운남성덕굉주미경항병독치료적HIV-1감염자적기인형분포화내약독주전파수평.방법 근거HIV내약경계선조사실시방안,대2013년1-8월덕굉주부합요구적54빈년령재16 ～ 25세,신발현적HIV-1감염자적혈장양본진행HIV-1기인형검측화내약독주전파수평분석.결과 48빈양본완성료기인형급내약감정,중국적점45.8％,면전적점54.2％.통과진화분석대pol구진행분형,주요적기인형포괄:C아형(41.7％)、URF(31.3％)、CRF01 AE(12.5％)、CRF07 BC(10.4％)、CRF08 BC(2.1％)화B아형(2.1％).중국적감염자중수위적기인형시C아형,이외적감염자중수위적기인형시URF.재1빈면전적양본서렬중검측도1개침대비핵감류반전록매억제제류약물적내약돌변위점(K103N),안조내약경계선적통계방법고산내약독주류행솔위＜5％.결론 본차조사제시덕굉주신보고적HIV-1감염자중존재복잡적기인형,HIV-1내약독주처우저도류행수평.위공제내약전파수평적상승,응진일보규범본지애자병항병독치료급관리,병침대과경전파개전포괄내약전파재내적상관감측.
Objective To study the HIV-1 genotypes and transmitted drug resistance (TDR) in Dehong prefecture of Yunnan province in 2013.Methods Referring to the guidelines for HIV drug resistance threshold survey (HIVDR-TS),54 plasma samples of recently reported HIV-infected individuals,aged between 16 and 25 years,were collected in Dehong prefecture from January to August 2013.Genotyping of partial pol gene was performed by using reverse transcriptional PCR.HIV-1 genotype.Prevalent levels of HIV-1 drug resistance transmission were analyzed.Results Forty-eight plasma samples were successfully sequenced and analyzed.Among them,45.8％ were Chinese and the rest 54.2％ were all Burmese.Based on pol sequences,identified HIV genotypes included subtype C (41.7％),URF (31.3％),CRF0 1_AE (12.5％),CRF07_BC (10.4％),CRF08_BC (2.1％) and subtype B (2.1％),C subtype appeared dominated in Chinese while URF was dominated in Burmese.One drug resistant mutation to non-nucleoside reverse transcriptase inhibitors (NNRTIs) was detected in one sequence from Burmese.Based on the statistical method of HIVDR-TS,the prevalence of transmitted HIV-1 drug resistance was adjusted as ＜5％.Conclusion Diverse HIV-1 genotypes were found in this study,and the current HIV-1 drug resistant strains transmission was catalogued as at low prevalence level,in Dehong.To prevent the increase of the prevalence of transmitted HIV-1 drug resistance,standard treatment and scientific management for people living with HIV/AIDS should be strictly followed.Meanwhile,relevant surveillance,including drug resistance surveillance should also be performed among cross-border migrant population.