ABSTRACT
Objective To understand the major genotype-resistant mutation sites and change trends of HIV/AIDS patients with failure of antiviral therapy (ART) in Lincang City, Yunnan Province. Methods The In-House method was used to amplify the Pol gene region in the plasma samples of HIV/AIDS patients with failure of ART in Lincang City from 2011 to 2018. The target sequence was spliced and submitted to the HIV resistance database to identify and analyze the HIV-1 subtypes and resistant mutation sites. Results The 950 strains of HIV/AIDS patients with antiviral failure were mainly CRF08_BC, accounting for 75.5% (717/950), and the total gene mutation rate was 67.1% (637/950), which was dominated by non-nucleoside reverse transcriptase inhibitors (NNRTIs), accounting for 62.4% (593/950); followed by nucleoside reverse transcriptase inhibitors (NRTIs), accounting for 34.7% (330/950); protease inhibitors (PIs) was 7.5% (71/950). A total of 15 NRTIs of resistance-related mutation sites were detected, mainly M184V (29.3%) which was detected mostly in AZT/D4T+3TC+NVP programs; including 17 kinds of NNRTIs, mainly was K103N/S (25.1%)，the most detected in AZT/TDF+3TC+EFV programs. There were 22 kinds of PIs，mainly secondary sites were L10F/V/I (2.2%) and L33F (2.1%). The top three NRTIs mutation sites in the area were changed from T69D/N/G，M184I/V and D67N/G/S to M184I/V, K70R/Q/E/T and T215Y/F/V/I/N/A/D. NNRTIs mutation sites were changed from V179D/T/E/F, E138A/K/G/R and Y181C/F/G/V to K103N/S, E138A/K/G/R and V179D/T/E/F. The mutation sites of the first three PIs did not change much. Conclusions The second-line regimen based on PIs is a better choice in free antiviral treatments. Mastering the drug resistance of different gene mutations is beneficial to the compatibility of first-line drugs, thus delaying the use of second-line drugs.
ABSTRACT
Objective To analyze the molecular epidemiological characteristics of 38 HIV-1 positive seroconcordant couples in Yunnan Province. Methods The samples of HIV-1 antibody screened initially and positive confirmed in the Laboratory of Yunnan Provincial Infectious Diseases Specialist Hospital from 2014 to 2016 and laboratory data were collected. 41 samples from HIV-1 positive seroconcordant couples were selected and sequenced by RT-nested-PCR amplification. After the sequences were aligned and spliced, the qualified pol gene region sequence was used to construct phylogenetic tree and analyze subtypes, and the gene distance differences between each positive couple were calculated. Results A total of 76 pol gene regions from 38 HIV-1 positive seroconcordant couples were obtained. The major gene subtypes included CRF08_BC (45,59.2%), CRF07_BC (18,23.7%) and CRF01_AE (7,9.2%), there were also C (4, 5.3%) and B (2, 2.6%). Phylogenetic tree analysis and gene distance calculation clearly showed that HIV transmission between relationship partners occurred in 9 HIV-1 positive seroconcordant couples. Conclusions As the proportion of sexual transmission of HIV has risen year by year, the transmission between husband and wife should be the focus of our attention. Late diagnosis of HIV infection is the main factor that causes the transmission between husband and wife. For special populations, monitoring and testing should be strengthened as soon as possible, so as to reduce the occurrence of transmission between AIDS couples.
ABSTRACT
Objective To understanding the genetic subtype and its population and regional distribution of HIV-1 strains circulating in Yunnan province.Methods 788 plasma specimens collected in 2008-2009 from 15 distracts of Yunnan,were enrolled.Viral RNA were extracted and subjected to RT-PCR.1584 bp full length gag gene,3147 bp full length pol gene and 558 bp env (C2V3) fragment were amplified and directly sequenced.Full length gag and pol genes were connected together as a complete genetic region (location on HXB2:790-5096) for genotyping.Results Of the 788 plasma specimens,a total number of 1728 genomic sequences including 599 gag,564 pol and 525 env (C2V3) were successfully amplified and sequenced,with genotype of 617 samples identified.The subtypes of HIV-1 strains circulated in Yunnan were with the order of constituent ratio CRF08_BC ( 50.2％ ),CRF01_AE (25.0％),unknown recombinant forms ( 10.2％ ),CRF07_BC (9.2％),subtype C (2.9％) and subtype B (B') (2.4％).The distributions of subtypes showed significant regional differences and could be roughly divided into two forms:the CRF08_BC predominant areas represented by Lincang and Kunming,and the areas with CRF08_BC together with CRF01_AE coexistence,represented by Dehong and Xishuangbanna.The unknown recombinant forms accounted for more HIV infection in ethnic minorities (17.0％) than in ethnic Han (6.7％,P＜0.01 ).The distribution of subtypes varied significantly in the two primary routes of transmission for those infected through heterosexual contact.CRF08_BC and CRF0 1_AE were the dominant subtypes,accounting for 52.7％ and 29.1％ respectively.However,in IDUs,CRF08_BC strains accounted for half of the infection,while only 4.5％ of the infections were caused by CRF01_AE,CRF07_BC while the unique recombinant forms were responsible for 15.5％ infections.Of the 63 unknown recombinant forms,most (74.6％) were B (B' ) recombinant with C,while 25％ were mosaic B and/or C fragments on the bases of CRF01_AE genome.Conclusion The subtypes of HIV-1 strains circulated in Yunnan were complicated under the significant differences of regions,ethnics or routes of transmission.