关键词: HIV, 基因型, 系统进化分析, 耐药性, 分子特征, 福建省

Abstract: Objective　To investigate the HIV⁃1 genotype and distribution of newly diagnosed HIV⁃1 cases in Fujian Province in 2020, so as to provide insights into formulation of the precise AIDS control strategy in the province. Methods　Newly diagnosed HIV⁃1 cases without antiretroviral therapy (excluding AIDS patients) were randomly sampled from each city of Fujian Province in 2020 at a proportion of 50% of the mean number of HIV⁃infected cases reported across 9 cities of Fujian Province during the past three years. Subjects’ demographic and epidemiological data were collected and blood samples were collected. The HIV⁃1 pol gene was amplified using nested reverse⁃transcription PCR assay, and the gene sequences were used for HIV⁃1 genotyping and phylogenetic analysis. The gene sequences were uploaded to the HIV Drug Resistance Database (http://hivdb.stanford.edu) for genotypic drug resistance assays, and the scores and level of HIV drug resistance were estimated using the HIVDB Algorithm version 9.5. Results　A total of 1 043 newly diagnosed HIV⁃1 cases were reported in Fujian Province in 2020, and 936 gene sequences were successfully obtained following sequencing of blood samples. There were 9 HIV⁃1 genotypes characterized in blood samples from 936 newly diagnosed HIV⁃1 cases, with CRF07_BC (52.1%) and CRF01_AE (30.4%) as predominant subtypes, followed by CRF08_BC (4.9%), CRF55_01B (3.0%), subtype C (2.5%), subtype B (2.1%), CRF85_BC (1.7%), CRF59_01B (0.3%) and CRF65_CPX (0.1%), and unidentified subtypes were found in 26 blood samples. HIV⁃1 drug resistance was detected in 43 out of the 936 newly diagnosed HIV⁃1 cases, with 4.6% prevalence of HIV⁃1 drug resistance prior to therapy, and the highest drug resistance was found in the HIV CRF59_01B subtype, followed by in CRF08_BC, B, C, CRF01_AE, CRF07_BC and other subtypes, with a significant difference in the genotype⁃specific prevalence of HIV⁃1 drug resistance ([χ2] = 45.002, P < 0.05). Conclusions　There was a HIV⁃1 genotype diversity in Fujian Province in 2020, and emerging recombinant and drug⁃resistant HIV⁃1 strains were detected and spread across patients and regions. Monitoring of HIV⁃1 genotypes is recommended to be reinforced for timely understanding of the transmission and spread of novel recombinant and drug⁃resistant HIV⁃1 strains.

Key words: Human immunodeficiency virus, Genotype, Phylogenetic analysis, Drug resistance, Molecular characteristic, Fujian Province