由于来自东欧的战争移民,原发性HIV-1耐药性的变化
Andrzej Załęski1,2, Agnieszka Lembas3,4, Tomasz Dyda1,5
1Hospital for Infectious Diseases in Warsaw, Warsaw, Poland.
Journal of immigrant and minority health
|November 16, 2023
概括
最近的移民把人类免疫缺陷病毒 (HIV) 带到了波兰. 一项研究发现,在乌克兰人中常见的HIV-1亚型A,在波兰人中常见的亚型B,在移民中没有增加耐药性HIV传播风险.
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:
- 来自东欧,特别是乌克兰,越来越多的人从东欧迁移到波兰,导致越来越多的人患有人类免疫缺陷病毒 (HIV).
- 了解这些人群中HIV的遗传亚型和耐药性模式对于有效的公共卫生策略和治疗至关重要.
- 抗逆转录病毒治疗 (ART) 对于治疗艾滋病毒至关重要,但药物耐药性的出现可能会使治疗结果复杂化.
研究的目的:
- 在移民到波兰的HIV阳性个体队伍中确定占主导地位的人类免疫缺陷病毒1型 (HIV-1) 亚型.
- 评估在从未接受过ART的患者中对关键抗逆转录病毒药物类 (NRTIs,NNRTI,PI) 的初级耐药性突变的患病率.
- 为了比较乌克兰和波兰患者之间的HIV-1亚型和耐药性模式.
主要方法:
- 一项多中心的前性研究在两年内 (2020-2022) 进行,涉及117名从未使用过ART的个人.
- 使用分子方法识别了HIV-1亚型.
- 基因型耐药性测试用于检测对核酸逆转录酶抑制剂,非核酸逆转录酶抑制剂和蛋白酶抑制剂产生耐药性的突变.
主要成果:
- 在乌克兰患者中,HIV-1亚型A显著更为普遍,而在波兰患者中,亚型B更为普遍 (p < 0.05).
- 在所有病例中,主要耐药性突变在44%中被检测出来.
- 在乌克兰和波兰患者之间,或在HIV-1亚型A和B之间 (p > 0.05) 没有观察到药物耐药性突变的流行有显著差异. 然而,波兰患者的多药耐药性突变频率较高 (p < 0.05).
结论:
- 该研究发现,在分析的乌克兰移民队伍中,没有发现多药耐药性HIV病毒株传播风险增加.
- 在乌克兰和波兰患者组之间观察到明显的HIV-1亚型分布.
- 虽然整体耐药性流行率相似,但波兰患者的多药性耐药性率更高,因此需要继续监测.
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