河南省2014-2016年不同城市新确证HIV感染者的亚型分布和耐药传播情况分析
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摘要
目的对河南省不同城市新确证HIV感染者的亚型分布和原发耐药情况进行比较。方法选取河南省五个市2014-2016年新确证HIV感染者中部分方便病例进行亚型和耐药性检测,对不同城市的亚型分布和原发耐药情况进行比较分析。结果共调查到598例HIV感染者,其中有425例得到了亚型和耐药的检测结果,包括南阳115例,郑州158例,商丘133例,安阳/三门峡19例。这些患者中男性居多(75.29%),多数为汉族(98.35%),多数在婚(54.12%),感染途径为异性传播的占72.71%,同性传播的占24.71%。亚型分布情况为:B′亚型占52.94%,CRF07_BC亚型占24.00%,CRF01_AE亚型占18.82%,其他亚型占4.24%。五个城市的CRF01_AE和其他亚型的分布差异无统计学意义(P>0.05),CRF07_BC和B′亚型的分布差异有统计学意义(P<0.05)。南阳市和商丘市以B′亚型为主,占比分别为64.35%和67.67%。安阳/三门峡以CRF07_BC亚型为主,占比为57.89%。郑州市CRF07_BC和B′亚型占比分别为33.54%和36.71%。河南省五个市新确证HIV感染者的原发耐药率为8.71%,五个城市的耐药株传播都达到中度流行水平。结论河南省不同城市的新确诊HIV感染者亚型分布不同,耐药传播达到中度流行水平。
Objective To compare the subtype and drug resistance of newly diagnosed HIV-infected persons in different cities of He′nan Province. Methods Samples among five cities of Henan Province from 2014 to 2016 were selected. Results A total of 598 HIV-infected patients were investigated. Among them,425 cases were analysed,including 115 cases from Nanyang,158 cases from Zhengzhou,133 cases from Shangqiu and 19 cases from Anyang/Sanmenxia. The majority of these patients were male(75.29%),mostly Han(98.35%) and married(54.12%),72.71% infected through homosexual transmission and 24.71% from same sexually transmitted B′ subtypes accounted for 52.94%,CRF07_BC accounted for 24.00%,CRF01_AE accounted for 18.82%,other subtypes accounted for 4.24%. There were no significant differences in distribution of CRF01_AE and other subtypes in five cities(P>0.05). The distributions of CRF07_BC and B′ subtypes were significantly different(P<0.05). The subtype of Shangqiu and Nanyang is B′,accounting for 64.35% and 67.67%,respectively. Anyang/Sanmenxia mainly CRF07_BC subtype,accounting for 57.89%. CRF07_BC and B′ subtype accounted for 33.54% and 36.71% respectively in Zhengzhou. The resistance rates at Henan Province were 8.71%. The transmission of drug resistance in all five cities reached a moderate epidemic level. Conclusion The distribution of subtype among newly diagnosed HIV-infections in different cities of He′nan Province were different,the transmission of drug resistance had reached a moderate epidemic level.
Objective To compare the subtype and drug resistance of newly diagnosed HIV-infected persons in different cities of He′nan Province. Methods Samples among five cities of Henan Province from 2014 to 2016 were selected. Results A total of 598 HIV-infected patients were investigated. Among them,425 cases were analysed,including 115 cases from Nanyang,158 cases from Zhengzhou,133 cases from Shangqiu and 19 cases from Anyang/Sanmenxia. The majority of these patients were male(75.29%),mostly Han(98.35%) and married(54.12%),72.71% infected through homosexual transmission and 24.71% from same sexually transmitted B′ subtypes accounted for 52.94%,CRF07_BC accounted for 24.00%,CRF01_AE accounted for 18.82%,other subtypes accounted for 4.24%. There were no significant differences in distribution of CRF01_AE and other subtypes in five cities(P>0.05). The distributions of CRF07_BC and B′ subtypes were significantly different(P<0.05). The subtype of Shangqiu and Nanyang is B′,accounting for 64.35% and 67.67%,respectively. Anyang/Sanmenxia mainly CRF07_BC subtype,accounting for 57.89%. CRF07_BC and B′ subtype accounted for 33.54% and 36.71% respectively in Zhengzhou. The resistance rates at Henan Province were 8.71%. The transmission of drug resistance in all five cities reached a moderate epidemic level. Conclusion The distribution of subtype among newly diagnosed HIV-infections in different cities of He′nan Province were different,the transmission of drug resistance had reached a moderate epidemic level.
引文
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[2] Hemelaar J.The origin and diversity of the HIV-1 pandemic [J].Trends Mol Med,2012,18(3):182-192.
[3] Su Y,Liu H,Wu J,et al.Distribution of HIV-1 genotypes in China:a systematic review] [J].Zhonghua Liu Xing Bing Xue Za Zhi,2014,35(10):1164-1168.
[4] WHO.WHO HIV drug resistance report 2012 [M].Geneva:World Health Organazation,2012.
[5] Liao L,Xing H,Shang H,et al.The prevalence of transmitted antiretroviral drug resistance in treatment-naive HIV-infected individuals in China [J].J Acquir Immune Defic Syndr,2010,53 (Suppl 1):S10-14.
[6] Zhong P,Pan Q,Ning Z,et al.Genetic diversity and drug resistance of human immunodeficiency virus type 1 (HIV-1) strains circulating in Shanghai [J].AIDS Res Hum Retroviruses,2007,23(7):847-856.
[7] Bennett DE,Myatt M,Bertagnolio S,et al.Recommendations for surveillance of transmitted HIV drug resistance in countries scaling up antiretroviral treatment [J].Antivir Ther,2008,13 (Suppl 2):25-36.
[8] Li Y,Uenishi R,Hase S,et al.Explosive HIV-1 subtype B′ epidemics in Asia driven by geographic and risk group founder events [J].Virology,2010,402(2):223-227.
[9] Su B,Liu L,Wang F,et al.HIV-1 subtype B′ dictates the AIDS epidemic among paid blood donors in the Henan and Hubei provinces of China [J].AIDS,2003,17(17):2515-2520.
[10] A Guide for Health Departments.Detecting,Investigating,and Responding to HIV Transmission Clusters[Z].Draft Version 2.0.National Center for HIV/AIDS,Viral Hepatitis,STD,TB Prevention,2018.
[11] Su L,Graf M,Zhang Y,et al.Characterization of a virtually full-length human immunodeficiency virus type 1 genome of a prevalent intersubtype (C/B′) recombinant strain in China [J].J Virol,2000,74(23):11367-11376.
[12] Feng Y,Takebe Y,Wei H,et al.Geographic origin and evolutionary history of China′s two predominant HIV-1 circulating recombinant forms,CRF07_BC and CRF08_BC [J].Sci Rep,2016,6:19279.
[13] Meng Z,Xin R,Zhong P,et al.A new migration map of HIV-1 CRF07_BC in China:analysis of sequences from 12 provinces over a decade [J].PLoS One,2012,7(12):e52373.
[14] Krentz HB,Ko K,Beckthold B,et al.The cost of antiretroviral drug resistance in HIV-positive patients [J].Antivir Ther,2014,19(4):341-348.
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