| Objective:To study the prevalence of HIV-1 genotype resistance mutation and subtype recombination in Honghe Prefecture of Yunnan Province,to master the characteristics of genotypic drug resistance mutations in this region,and to analyze the molecular epidemiology of HIV-1 genotypes for HIV/AIDS treatment in the region and provide theoretical basis.Reserch method:Research object: To study the drug resistance of HIV/AIDS in adults who failed to undergo antiviral therapy from 2012 to 2016 in Honghe Prefecture,and to select the subtypes and recombination mutations of HIV/AIDS in adults who failed antiviral treatment from 2015 to 2016.Methods: HIV-1 drug resistance studies were performed using the In-house method.The pol region was amplified and sequenced.Conting Express software and BioEdit software were used to splice and verify the sequences.After completion,they were submitted to Stanford University's AIDS drug resistance database.To analyze the drug resistance of HIV-1 strains and the mutation characteristics of drug resistance sites.Subtypes and Recombinant Mutations Using RT-PCR for HIV-RNA extraction,amplification of HIV-1 5'-end and Near-Full-length Genomes,Genometyping,jpHMM,MEGA6.06,and BLAST Software to determine the strain subtype and recombinant type.Result:(1)A total of 1382 adult HIV/AIDS patients in Honghe Prefecture were detected in this study.There were 1186 positive PCR amplifications,of which 572 were drug resistant,and the incidence of drug resistance was 48.22%(572/1186).The rate of drug resistance occurred in the population was 4.64%(572/12306).The overall drug resistance rate was approximately 1% between 2012 and 2016,and the resistance rate was approximately 50% among people who failed antiviral treatment.In 1186 patients with positive amplification,male dominated,accounting for 67.6%(802/1186).(2)Reported results of 572 drug-resistant patients(any type of drug drug resistance),Nucleoside(acid)Reverse Transcriptase Inhibitors(NRTIs),and Non-Nucleoside Reverse Transcriptase Inhibitors(NNRTIs),and Protease Inhibitors(PIs)was 57.51%(329/572),89.68%(513/572),and 3.67%(21/572).Respectively,the resistance to NRTIs+NNRTIs was 48.77%.(3)In the treatment population,the overall frequency of drug resistance was highest in Luxi County Honghe Prefecture,accounting for 18.54%(105/569);In the population with failure of antiviral treatment,the frequency of drug resistance was highest in Pingbian County,accounting for 65.62%(21/32).Among the patients who failed antiviral therapy,Mengzi city has a higher frequency of resistance to NRTIs,accounting for 72.41%(21/29),and the rest is also about 50%;Luchun County has the highest frequency of resistance to NNRTIs,accounting for 100%(3/3);The frequency of resistance to PIs is low.(4)The frequency of NRTIs resistant mutations accounted for M184 V/I,T69 N,and A62 V,accounting for 36.36%(208/572),23.60%(135/572),and 18.18%(104/572),respectively.The highest proportion of resistance to drug didanosine(DDI)was 55.24%(316/572),followed by zidovudine(3TC)and abacavir(ABC),accounting for 40.04%(229/572))and 41.95%(240/572),statistically found that 3TC and FTC(emtricitabine)were highly resistant,with 36.71%(210/572)and 36.18%(207/572)respectively;The highest site of NNRTIs resistant mutation was K103 N,which accounted for 34.26%(196/572).The EFV and NVP showed the highest proportion of drug resistance,76.92%(440/572)and 77.09(441/572)respectively.At the same time,the highest level of drug resistance occurred at the highest level,reaching 58.21%(333/572)and 69.75%(399/572)respectively;the drug resistance mutations appearing in PIs are relatively rare.Six resistance mutations occurred after the mutation in the test results,and the frequency of drug resistance was less than 2%.(5)The distribution of HIV/AIDS subtypes in Honghe Prefecture was studied in 140 patients with failure of antiviral therapy and 114 positive-amplified sequences(including gag,pol,or 5'-half)were obtained.The HIV-1 subtype of Honghe Prefecture is dominated by CRF08_BC,accounting for 64.03%(73/114),followed by CRF07_BC,with a small amount of CRF01_AE,B(B')and C,and 4 URFs are found,and 4 URFs have two recombination models,one of model is CRF01_AE subtypes as the basic skeleton inserted C fragments,a total of 1 case,the other is that the C subtype is the basic skeleton and the B subtype fragment is inserted.There are 3 cases in total.Conclusion:(1)The overall incidence of drug resistance in Honghe Prefecture is not high,and the incidence of drug resistance in the population with antiviral failure is lower than the overall incidence of drug resistance in Yunnan Province.(2)NNRTIs were the highest,followed by NRTIs,and the incidence of PIs was the lowest.Multidrug resistance accounted for a certain percentage.The overall incidence of drug resistance was highest in LuXi County,and the incidence of drug resistance was highest in PingBian County in the population where antiviral treatment failed.The cities and counties are mainly resistant to NRTIs and NNRTIs,while the resistance to NNRTIs is the highest.(3)The highest resistance to NRTIs was M184 V/I,NNRTIs were K103 N,and PIs were less frequently found.The drug with the highest incidence of NRTIs resistance was 3TC,NNRTIs were EFV and NVP,and the incidence of PIs drug resistance was not high.(4)The distribution of subtypes of HIV-1 epidemic strains in Honghe Prefecture is complex and CRF08_BC is the predominant subtype.The common subtypes are CRF07_BC and CRF01_AE,and new recombinant strains are not found. |
PDF Full Text Request