林俊潇, 王红珠, 李聪聪, 盛盈, 李桂霞. 治疗失败的HIV感染者HIV-1亚型及耐药突变位点分析[J]. 上海预防医学, 2023, 35(3): 224-228. DOI: 10.19428/j.cnki.sjpm.2023.22360
引用本文: 林俊潇, 王红珠, 李聪聪, 盛盈, 李桂霞. 治疗失败的HIV感染者HIV-1亚型及耐药突变位点分析[J]. 上海预防医学, 2023, 35(3): 224-228. DOI: 10.19428/j.cnki.sjpm.2023.22360
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LIN Junxiao, WANG Hongzhu, LI Congcong, SHENG Ying, LI Guixia. HIV-1 subtypes and drug-resistance mutation sites in HIV/AIDS patients with antiretroviral-therapy failure[J]. Shanghai Journal of Preventive Medicine, 2023, 35(3): 224-228. DOI: 10.19428/j.cnki.sjpm.2023.22360
Citation: LIN Junxiao, WANG Hongzhu, LI Congcong, SHENG Ying, LI Guixia. HIV-1 subtypes and drug-resistance mutation sites in HIV/AIDS patients with antiretroviral-therapy failure[J]. Shanghai Journal of Preventive Medicine, 2023, 35(3): 224-228. DOI: 10.19428/j.cnki.sjpm.2023.22360
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治疗失败的HIV感染者HIV-1亚型及耐药突变位点分析

HIV-1 subtypes and drug-resistance mutation sites in HIV/AIDS patients with antiretroviral-therapy failure

    摘要
  • 摘要:
    目的 分析接受高效抗逆转录病毒治疗但失败的艾滋病病毒（HIV）感染者的HIV⁃1亚型特征及耐药突变位点情况。
    方法 收集2021年浙江省台州市接受抗病毒治疗满6个月，但治疗失败且病毒载量≥1 000拷贝·mL-1的病例血浆标本130例，提取病例的核酸，通过逆转录聚合酶链反应（PCR）和靶向扩增得到pol区基因，经一代测序后，使用在线工具比对，进行亚型及耐药突变位点分析。
    结果 110例成功测序者中主要的HIV⁃1亚型是CRF01_AE型（占42.72%，47例）以及CRF07_BC型（占35.45%，39例）；其次是CRF08_BC和CRF85_BC，分别有11例和9例，占比为10.00%和8.18%；还有少数的B亚型和C亚型，各有2例，占比均为1.81%。在线工具比对显示出现耐药位点突变者67例，发生耐药者61例。其中突变位点主要为M184V、K103N、K65R和V181C，突变率分别为20.00%（22例）、10.91%（12例）、8.18%（9例）和8.18%（9例）。这些突变位点分别引起对核苷类反转录酶抑制剂（NRTI），非核苷类反转录酶抑制剂（NNRTI）和蛋白酶抑制剂（PI）类药物不同程度的耐药，其中NRTI 45例，NNRTI 61例，PI耐药2例。
    结论 治疗失败的HIV感染者主要为CRF01_AE和CRF07_BC亚型。耐药突变率处于中等水平，主要是NRTI和NNRTI耐药位点突变以及个别PI耐药位点突变。对HIV感染者的抗病毒治疗方案应合理调整，并加强对耐药突变位点的检测，避免产生传播性耐药毒株。

     

    Abstract:
    Objective To analyze the characteristics of HIV-1 subtypes and drug-resistance mutation sites among HIV-infected patients who received high-efficiency antiretroviral therapy but failed.
    Methods A total of 130 plasma samples were collected from the patients who received antiviral treatment for 6 months in Taizhou City of Zhejiang Province in 2021 but failed the treatment and the viral load was ≥1 000 copies·mL-1. Nucleic acid in the samples was extracted， and the pol gene was amplified by nested reverse transcription PCR. After next-generation sequencing， online tools were used to compare and analyze the subtypes and drug-resistant mutation sites.
    Results A total of 110 samples were successfully sequenced. The main HIV-1 subtype was CRF01_AE， accounting for 42.72% （47 cases）， followed by CRF07_BC， 35.45% （39 cases）； CRF08_BC， 10.00% （11 cases）； CRF85_BC， 8.18% （9）； and a small number of B subtype， 1.81% （2 cases） and C subtype， 1.81% （2 cases）. The online tool comparison showed that there were 67 cases with mutations of drug-resistance sites and 61 cases with drug-resistance. The mutation sites were mainly M184V， K103N， K65R and V181C， and the mutation rates were 20.00% （22 cases）， 10.91% （12 cases）， 8.18% （9 cases） and 8.18% （9 cases）， respectively. These mutation sites caused different degrees of resistance to nucleoside reverse transcriptase inhibitors （NRTI）， non- nucleoside reverse transcriptase inhibitors （NNRTI） and protease inhibitors （PI）， including 45 cases of NRTI， 61 cases of NNRTI and 2 cases of PI resistance.
    Conclusion The HIV infected people who fail the treatment in Taizhou are mainly with the subtypes CRF01_AE and CRF07_BC. The rate of drug-resistance mutation is at a moderate level， mainly due to the mutation of NRTI and NNRTI drug-resistance sites， and a small number of PI drug-resistance sites. Therefore， the antiviral treatment plan for HIV infected people should be reasonably adjusted， and the detection of drug-resistance mutation sites should be strengthened to avoid the generation of transmissible drug-resistance strains.

     

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