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目的:采用分层整群随机抽样原则,对本市95例已确诊的人类免疫缺陷病毒-1(HIV-1)感染者进行基因亚型和耐药性突变研究,以了解上海市HIV-1基因亚型及耐药性HIV-1的流行情况。方法:应用巢式RT-PCR扩增HIV-1聚合酶基因,经DNA测序后进行进化系统树分析和重组分析,以确定HIV-1基因亚型和重组体,并与国际耐药数据库比对,辨别耐药性突变位点,结合流行病学资料进行分析。结果:①在95例本市HIV感染者中经RT-PCR扩增并获得基因亚型序列70例,基因分型以CRF01_AE重组体30例(42.9%)为主,其余分别为B亚型6例(8.6%)、B’亚型10(4.3%)、G亚型2例(2.9%)、K亚型1例(1.4%)、CRF02_AG3例(4.3%)、CRF07_BC8例(11.4%)和CRF08_BC7例(10.0%),亚型间或重组体间二重重组体(CRF02_AG/CRF01_AE、B/CRF01_AE、K/G)3例(4.3%);②耐药分析结果表明,本组人群的蛋白酶抑制剂(PIs)原发耐药突变率为4.3%。在抗病毒治疗的HIV感染者15例中,11例(73.3%)发生反转录酶抑制剂(RTIs)耐药基因突变,其中核苷和非核苷类反转录酶抑制剂的耐药突变率分别为10例和11例(66.7%和73.3%),远高于未治疗者。结论:本研究分析了上海市HIV-1基因亚型和耐药突变的流行与变迁情况,对HIV-1遗传变异多样性和耐药监测体系的建立及上海市的艾滋病预防和控制工作有重要指导意义。
OBJECTIVE: To investigate the mutation of HIV-1 and HIV-1 in 95 confirmed cases of HIV-1 in Shanghai by using the stratified cluster random sampling principle to understand the mutations of HIV-1 gene Subtype and the prevalence of drug-resistant HIV-1. Methods: The HIV-1 polymerase gene was amplified by nested RT-PCR. After DNA sequencing, phylogenetic tree analysis and recombination analysis were performed to identify HIV-1 subtypes and recombinants and to compare with the international drug resistance database , Identify the site of resistance mutations, combined with epidemiological data for analysis. Results: (1) Seventy-five cases of genomic subtypes were amplified by RT-PCR from 95 HIV-infected patients in our city. The genotypes were genotyped with 30 cases (42.9%) with CRF01_AE recombinants and the rest were subtype B (8.6%), B ’subtype 10 (4.3%), G subtype 2 (2.9%), K subtype 1 (1.4%), CRF02_AG3 (4.3%) and CRF07_BC (11.4%) and 3 cases (4.3%) of CRF08_BC were found in 7 (10.0%), 2 subgroups or 2 recombinant recombinants (CRF02_AG / CRF01_AE, B / CRF01_AE and K / G); ②Results of drug resistance analysis showed that protease inhibition Agents (PIs) primary resistance mutation rate of 4.3%. Of 15 HIV-infected patients with antiviral therapy, 11 (73.3%) had reverse-transcriptase resistance (RTIs) gene mutations, including mutations in both nucleoside and non-nucleoside reverse transcriptase inhibitors The rates were 10 and 11 (66.7% and 73.3%, respectively), much higher than those in the untreated group. Conclusions: This study analyzed the prevalence and changes of HIV-1 genotypes and drug-resistant mutations in Shanghai. It is important to establish the diversity of HIV-1 genetic diversity and drug resistance surveillance system and AIDS prevention and control in Shanghai. Guiding significance.