在德国报告的新艾滋病毒诊断中传播的耐药性和病毒亚型模式,2017-2020年
Uwe Fiebig1, Britta Altmann2, Andrea Hauser2
1Unit 18 "HIV and other Retroviruses, Sexually transmitted bacterial Pathogens (STI) and HIV", Department of Infectious Diseases, Robert Koch Institute, Berlin, Germany.
BMC infectious diseases
|October 10, 2023
概括
初级HIV耐药性仍然很高但稳定,需要在治疗前进行基因型耐药性测试. 也观察到越来越多的HIV-1亚型多样性,影响治疗策略.
科学领域:
- 病毒学 病毒学
- 流行病学 流行病学
- 公共卫生 公共卫生
背景情况:
- 抗性HIV变种威胁到抗逆转录病毒疗法和预防疗法的有效性.
- 对新的艾滋病毒诊断的分子监测对于监测耐药性突变和病毒亚型至关重要.
研究的目的:
- 分析德国新诊断的感染中耐药性突变和HIV-1亚型的流行率和趋势.
- 评估对当前和未来的艾滋病毒治疗策略的影响.
主要方法:
- 来自德国 (2017-2020年) 报告的11,527例新艾滋病毒诊断的蛋白酶,逆转录酶和整合酶序列的分析.
- 基因型数据与国家艾滋病毒监测报告的相关性.
主要成果:
- 主要耐药性的流行率:4.3% (NRTIs),9.2% (NNRTIs),3.3% (PIs),1.4% (INIs) 的. 双类耐药性 (NRTI/NNRTI) 是1.2%.
- 像K103NS这样的关键抗性突变显示出显著增加 (2.9%).
- 艾滋病毒-1亚型B是最常见的 (58.7%),但正在下降,少数亚型的频率正在增加. 亚型B在与男性发生性关系 (MSM) 的男性中最高.
结论:
- 初级HIV耐药性高但稳定,强调在开始治疗之前需要进行基因型耐药性测试.
- 流通的HIV-1亚型的多样性越来越多,需要持续监测和治疗指南的潜在调整.
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