目的 分析安徽省蚌埠市2021—2022年新报告HIV感染者基因亚型、治疗前耐药特征和HIV分子传播网络情况,为当地制定干预措施提供依据。方法 收集蚌埠市2021—2022年新报告HIV感染者样本90份,扩增pol基因并测序,借助Blast HIV sequence database对每条序列进行同源性分析,采用MEGA 7.0构建NJ系统进化树判定所有HIV感染者基因亚型。将所得序列上传至美国斯坦福大学HIV耐药数据库,分析基因型耐药情况。利用Cytoscape实现传播网络的可视化,分析新报告HIV感染者耐药传播特点和网络关联情况。结果 蚌埠市85例新报告HIV感染者基因亚型主要为CRF01_AE(58.82%)和CRF07_BC(23.53%),耐药率为10.59%(9/85),主要为非核苷类药物耐药(5/85,5.88%)。在0.5%基因距离阈值下的分子传播网络中,CRF01_AE入网率为44%,存在1个较大的耐药传播簇,耐药位点为L33F;CRF07_BC入网率为10%。分子传播网络中的HIV感染者主要为五河县50岁及以上男性,文化程度较低。结论 蚌埠市新报告HIV感染者耐药率较高,形成了耐药传播簇,传播风险较高,应采取有效措施进行干预,减少 HIV的传播。

Objective To analyze the HIV genotype,drug resistance characteristics before treatment and HIV molecular transmission network of newly reported HIV infections from 2021 to 2022 in Bengbu City,Anhui Province,in order to provide a basis for the formulating of local intervention measures. Methods 90 samples of newly reported HIV infections in Bengbu City from 2021 to 2022 were collected,pol genes were amplified and sequenced,the homology analysis of each sequence was analyzed with the help of Blast tool HIV sequence database,and MEGA 7.0 was used to construct the NJ system evolutionary tree to determine HIV genotypes of all HIV infections.The resulting sequences were uploaded to the HIV resistance database of Stanford University to analyze genotype resistance.The transmission network was visualized by Cytoscape to analyze the transmission characteristics of drug resistance and the network association of newly reported HIV infections in Bengbu City. Results The main genotypes of 85 newly reported HIV infections in Bengbu City were CRF01_AE (58.82%) and CRF07_BC(23.53%),the drug resistance rate was 10.59% (9/85).It was mainly resistant to non-nucleoside reverse transcriptase inhibitors(5/85,5.88%).Analysis of the molecular propagation networks at the 0.5% gene distance threshold,the CRF01_AE access rate was 44%,and there was a large resistance spread cluster in which the resistance site was L33F.The CRF07_BC access rate was 10%.The main HIV infected individuals in the molecular transmission network were males aged 50 and above in Wuhe County,with a relatively low level of education. Conclusion The drug resistance rate of newly reported HIV infections in Bengbu City is high,forming a drug-resistant transmission cluster and posing a high risk of transmission.Effective measures should be taken to reduce the transmission of HIV.