Objective This study aims to realizethe epidemiological characteristics and prevalence of drug resistance among newly-diagnosed HIV infected/AIDS of elderly people aged ≥50 years in Longgang District of Shenzhen, to provide reference data of AIDS prevention and control strategies for the elderly.
Methods A cross-sectional study of epidemiology was carried out on newly reported HIV/AIDS infections among ≥50-year-old population in Longgang District during 2016–2019. Plasma samples were selected by random sampling, and its RNA were extracted. The pol gene segments of HIV-1 genome from these RNA samples were amplified and sequenced by nested reverse transcription polymerase chain reaction (nested-RT-PCR). HIV subtype were determined through phylogenetic tree produced by Neighbor-Joining method. The sequence data were submitted to Stanford University HIV Drug Resistance Database for drug resistance analysis.
Results From 2016 to 2019, 253 HIV/AIDS cases ≥50 years old were newly reported in Longgang district, and the proportion of cases ≥50 years old in each year from 2016 to 2018 was 14.41%, 17.34% and 18.41%, showing an increasing trend. Among them, the majority were males (77.47%, 196/253) and migrants (71.54%, 181/253), and were infected mainly through heterosexual behavior (75.10%, 190/253). A total of 48 HIV-1 pol gene sequences were obtained and analyzed. Five HIVsubtypes of CRF01_AE, CRF07_BC, CRF55_01B, B, G were found, and which CRF01_AE, CRF07_BC were the predominant subtypes. Four cases with drug resistant mutations, and 8 cases with potential drug resistant mutations were found, and the prevalence of transmitted drug resistance was 8.33%.
Conclusions The prevalence of drug resistance among newly-diagnosed HIV infected of elderly people aged ≥50 years remained at intermediate level, and potential drug resistant mutations were high. It is necessary to strengthen drug resistance monitoring in new report HIV/AIDS infections among 50-year-old population.
摘要： 目的 了解深圳市龙岗区新增确证 ≥50岁老年艾滋病病毒感染者 (HIV)/艾滋病病人 (AIDS) 的流行病学特 征及耐药状况，为制定老年艾滋病防控策略提供参考数据。 方法 对龙岗区 2016—2019 年新报告 ≥50 岁老年 HIV/AIDS 开展流行病学横断面研究，对随机选取的血清样本提取病毒 RNA, 采用巢式RT-PCR法扩增HIV-1 pol区基因 片段并测序，以邻接法 (Neighbor-Joining method, NJ) 构建系统进化树确定基因亚型，并将测序结果上传至美国斯坦 福大学HIV耐药数据库进行耐药分析。 结果 龙岗区 2016—2019 年新报告 ≥50岁HIV/AIDS数 253例, 2016—2018 年 各年 ≥50岁病例构成比分别为14.41%、17.34%、18.41, 呈上升趋势。 男性占比最高 (77.47%, 196/253), 外省户籍居多 (71.54%, 181/253), 传播途径以非婚异性传播为主 (75.10%, 190/253)。 对扩增成功的48份 pol 基因序列分析共发现 CRF01_AE、CRF07_BC、CRF55_01B、B及G 5种基因亚型，以CRF01_AE和CRF07_BC为优势亚型;4例感染者携带耐 药突变位点，总耐药率为8.33%, 8例感染者具有潜在耐药突变位点，。 结论 深圳市龙岗区新增确证老年 HIV/AIDS 患者的原发性耐药率处于中度流行水平，且潜在耐药突变较高，有必要加强 HIV 耐药监测。