目的:分析上海市人类免疫缺陷病毒(human immunodeficiency virus,HIV)1型(HIV-1)感染者的分子流行特征及影响因素,为制定有效干预措施提供科学依据。方法:收集2015年至2018年新报告的HIV-1感染者血清样本1322例,通过巢式PCR扩增HIV-1po...目的:分析上海市人类免疫缺陷病毒(human immunodeficiency virus,HIV)1型(HIV-1)感染者的分子流行特征及影响因素,为制定有效干预措施提供科学依据。方法:收集2015年至2018年新报告的HIV-1感染者血清样本1322例,通过巢式PCR扩增HIV-1pol区基因序列,根据pol基因序列进行病毒亚型分析,基于最适基因距离构建分子网络,分析分子网络特征及其影响因素。结果:1322例血清样本共获得1241条HIV-1pol区基因序列,发现12种HIV基因型,以CRF01_AE和CRF07_BC亚型为主,分别占50.93%和34.00%。有530条序列进入分子网络,入网率为42.71%(530/1241),共形成95个传播簇,簇内节点数为2~219个,其中有一个大簇,节点数为219个(41.32%,219/530)。入网率最高的亚型是CRF07_BC(59.48%,251/422),其次是01B(52.46%,32/61)和CRF01_AE(34.55%,218/631)。男男性行为传播相较于异性性传播更容易形成网络。结论:2015年至2018年上海市HIV-1基因亚型多样,以CRF01_AE和CRF07_BC亚型为主要优势毒株,分子网络呈聚集性分布,男男性接触者(men who have sex with men,MSM)HIV-1感染者具有更快的病毒传播能力,导致更高的感染率,更易进入网络成为高风险传播者。加强HIV-1分子监测可及时了解毒株在不同人群中的传播动态,可帮助公共卫生部门采取有效的干预措施。展开更多
目的了解2011—2020年大连市无偿献血人群的HIV耐药性突变的分布和传播趋势。方法对2011—2020年大连市无偿献血者HIV感染标本的PR-RT序列进行检测,利用The Stanford HIV Drug Resistance Database分析标本耐药性突变和耐药程度。结果在...目的了解2011—2020年大连市无偿献血人群的HIV耐药性突变的分布和传播趋势。方法对2011—2020年大连市无偿献血者HIV感染标本的PR-RT序列进行检测,利用The Stanford HIV Drug Resistance Database分析标本耐药性突变和耐药程度。结果在174份标本中共检测出30份携带耐药性突变(drug resistance mutation,DRM),DRM携带率为17.2%(30/174),传播性耐药(transmitted drug resistance,TDR)携带率为5.7%(10/174)。研究期间,DRM和TDR携带率在2019年出现大幅度升高,2020年分别达到44.4%、22.2%,均为历史最高水平。具备大专以上学历、本地常住特征的献血者其DRM携带率显著高于其他人群(P<0.05)。标本携带NNRTI类DRM占比最高(12.6%,22/174),PI类次之(5.7%,10/174),分别以V179D/E/T和M46I为主;仅1份(0.57%,1/174)携带NRTI类DRM(L74I)。标本整体耐药率为6.9%(12/174),以对NNRTI类药物耐药占比最高(83.3%,10/12);2份(1.1%,2/174)标本同时对一线推荐用药EFV和NVP高度耐药。基因型为CRF55_01B标本的DRM携带率显著高于其他基因型(P<0.05)。结论2019—2020年大连市无偿献血人群HIV耐药性突变携带率呈现明显上升趋势,对NNRTI类药物耐药标本占比最高。将ART实施前后的耐药性监测数据与最新版国家ART治疗方案相结合,有利于提高本地HIV防控效果。展开更多
Despite enormous efforts to achieve the goal of eliminating mother-to-child transmission of HIV-1, it remains a major challenge for many countries in sub-Saharan Africa, particularly Mali. Our objective is to assess c...Despite enormous efforts to achieve the goal of eliminating mother-to-child transmission of HIV-1, it remains a major challenge for many countries in sub-Saharan Africa, particularly Mali. Our objective is to assess changes in the rate of mother-to-child transmission of HIV-1. We conducted a cross-sectional study between January 1, 2009 to December 31, 2018 (10 years) of early diagnosis activity in newborns and children born to HIV-1-positive mothers at the National Institute for Public Health (INSP). The samples came from health and referral centers in mali. All samples were received at the Laboratory of Molecular Biology at the INSP. Proviral DNA extraction was performed from a blood spot sample with a Roche DNA kit, Cobas AmpliPrep/Cobas TaqMan HIV-1 qualitative Test, V2.0 (Roche Molecular System, Inc, USA) following the company procedures. Molecular diagnosis was performed using the same kits using an algorithm of three identical PCRs. The Epi Info version 7 software was used for data analysis with a significance threshold of 5%. A total of 10,714 samples of infants and children born to HIV-positive mothers were analyzed by PCR. Ninety-six percent of mothers were on ARV prophylaxis (AZT 3TC NVP and AZT NVP) and 60% of newborns received the same ARV prophylaxis. Of these children, 956 tested positive with an overall transmission rate of 8.92%, varying between 7.27% in 2009 and 08.01% in 2018. This rate was relatively low among children receiving prophylaxis at 2.04% and remained high for children who received breastfeeding at 5.62%. However, the transmission rate remains low for those who have benefited from mixed and artificial breastfeeding at 1.58% and 1.27% respectively. A significant proportion of children remained infected by their mothers during pregnancy, childbirth or breastfeeding. This study shows the importance of early diagnosis of HIV in children using molecular technology.展开更多
The emergence of antiretroviral resistance mutations represents a major threat to the achievement of national and global goals for the elimination of HIV-1 infection. The global strategy in 2019 in Cte d'Ivoire is...The emergence of antiretroviral resistance mutations represents a major threat to the achievement of national and global goals for the elimination of HIV-1 infection. The global strategy in 2019 in Cte d'Ivoire is a new national policy for the management of people living with HIV with the administration of dolutegravir (DTG)-based fixed-dose combination. The aim of our study was to evaluate HIV-1 resistance to antiretrovirals (ARVs) in infected adult subjects in Cte d’Ivoire in the context of a systematic switch to a DTG-based combination. Between February 2022 and October 2023, a cross-sectional survey with random sampling was conducted in 06 services caring for people living with HIV. A total of 139 participants were included in the study. Adults with a viral load ≥ 1000 copies/mL were tested for HIV-1 ARV resistance mutations. Molecular analyses were performed using protocol of ANRS-MIE (National Agency for Research on AIDS and emerging infectious diseases). The interpretation is performed by HIVGRAD (https://www.hiv-grade.de/cms/grade/). The frequencies of HIV-1 resistance to non-nucleotide reverse transcriptase inhibitors (NNRTIs), nucleotide reverse transcriptase inhibitors (NRTIs), integrase inhibitors (IINTs) and protease inhibitors (PIs) were 82%, 73%, 19% and 11% respectively. The main mutations observed in the different classes were K103N (45%), M184V (64%), E157Q (19%) and L10V/M46I/A71V/I54V (6%) respectively. This study reveals the emergence of resistance to DTG-based fixed-dose combinations, favored by high rates of resistance to NRTIs and NNRTIs. This finding underlines the need for enhanced viral load monitoring and HIV-1 genotyping tests to guide the choice of NRTIs for combination therapy. In addition, monitoring for mutations to second-generation NRTIs is essential, given the scale-up of DTG-based regimens currently underway in Cte d’Ivoire.展开更多
Introduction: HIV, the human immunodeficiency virus, is the etiological agent of acquired immunodeficiency syndrome (AIDS). The aim of this study was to assess the evolution of the viral load in patients under treatme...Introduction: HIV, the human immunodeficiency virus, is the etiological agent of acquired immunodeficiency syndrome (AIDS). The aim of this study was to assess the evolution of the viral load in patients under treatment. Methodology: This was a study carried out from July 2017 to June 2022 at the Point G University Hospital laboratory. The determination of the viral load of patients was carried out by PCR on the ABOTT M2000sp/rt platform. Results: A total of 129 patients infected with HIV-1, aged 19 to 72 years with a mean age of 40.05 years ± 10.71;all on antiretroviral chemotherapy. The female gender predominated among our patients. The most common treatment regimen was 2INTI + 1INNTI with 72.9% followed by 2INTI + 1INI with 13.2%. As for the combinations of molecules, the combination TDF + 3TC + EFV and TDF + 3TC + DTG predominated, respectively 65.1% and 13.2%. 89.9% of our patients had undetectable viremia after 12 months of treatment (p < 0.005) with an average viral load which had evolved from 681315.65 copies/ml ± 1616908.484 to M0 at 5742.36 copies /ml ± 35756.883 at M12 (p Conclusion: Generally speaking, antiretroviral treatment had contributed to controlling viral loads, however the therapeutic combination TDF + 3TC + DTG had made it possible to obtain more patients with undetectable viremia instead.展开更多
文摘目的:分析上海市人类免疫缺陷病毒(human immunodeficiency virus,HIV)1型(HIV-1)感染者的分子流行特征及影响因素,为制定有效干预措施提供科学依据。方法:收集2015年至2018年新报告的HIV-1感染者血清样本1322例,通过巢式PCR扩增HIV-1pol区基因序列,根据pol基因序列进行病毒亚型分析,基于最适基因距离构建分子网络,分析分子网络特征及其影响因素。结果:1322例血清样本共获得1241条HIV-1pol区基因序列,发现12种HIV基因型,以CRF01_AE和CRF07_BC亚型为主,分别占50.93%和34.00%。有530条序列进入分子网络,入网率为42.71%(530/1241),共形成95个传播簇,簇内节点数为2~219个,其中有一个大簇,节点数为219个(41.32%,219/530)。入网率最高的亚型是CRF07_BC(59.48%,251/422),其次是01B(52.46%,32/61)和CRF01_AE(34.55%,218/631)。男男性行为传播相较于异性性传播更容易形成网络。结论:2015年至2018年上海市HIV-1基因亚型多样,以CRF01_AE和CRF07_BC亚型为主要优势毒株,分子网络呈聚集性分布,男男性接触者(men who have sex with men,MSM)HIV-1感染者具有更快的病毒传播能力,导致更高的感染率,更易进入网络成为高风险传播者。加强HIV-1分子监测可及时了解毒株在不同人群中的传播动态,可帮助公共卫生部门采取有效的干预措施。
文摘目的了解2011—2020年大连市无偿献血人群的HIV耐药性突变的分布和传播趋势。方法对2011—2020年大连市无偿献血者HIV感染标本的PR-RT序列进行检测,利用The Stanford HIV Drug Resistance Database分析标本耐药性突变和耐药程度。结果在174份标本中共检测出30份携带耐药性突变(drug resistance mutation,DRM),DRM携带率为17.2%(30/174),传播性耐药(transmitted drug resistance,TDR)携带率为5.7%(10/174)。研究期间,DRM和TDR携带率在2019年出现大幅度升高,2020年分别达到44.4%、22.2%,均为历史最高水平。具备大专以上学历、本地常住特征的献血者其DRM携带率显著高于其他人群(P<0.05)。标本携带NNRTI类DRM占比最高(12.6%,22/174),PI类次之(5.7%,10/174),分别以V179D/E/T和M46I为主;仅1份(0.57%,1/174)携带NRTI类DRM(L74I)。标本整体耐药率为6.9%(12/174),以对NNRTI类药物耐药占比最高(83.3%,10/12);2份(1.1%,2/174)标本同时对一线推荐用药EFV和NVP高度耐药。基因型为CRF55_01B标本的DRM携带率显著高于其他基因型(P<0.05)。结论2019—2020年大连市无偿献血人群HIV耐药性突变携带率呈现明显上升趋势,对NNRTI类药物耐药标本占比最高。将ART实施前后的耐药性监测数据与最新版国家ART治疗方案相结合,有利于提高本地HIV防控效果。
文摘Despite enormous efforts to achieve the goal of eliminating mother-to-child transmission of HIV-1, it remains a major challenge for many countries in sub-Saharan Africa, particularly Mali. Our objective is to assess changes in the rate of mother-to-child transmission of HIV-1. We conducted a cross-sectional study between January 1, 2009 to December 31, 2018 (10 years) of early diagnosis activity in newborns and children born to HIV-1-positive mothers at the National Institute for Public Health (INSP). The samples came from health and referral centers in mali. All samples were received at the Laboratory of Molecular Biology at the INSP. Proviral DNA extraction was performed from a blood spot sample with a Roche DNA kit, Cobas AmpliPrep/Cobas TaqMan HIV-1 qualitative Test, V2.0 (Roche Molecular System, Inc, USA) following the company procedures. Molecular diagnosis was performed using the same kits using an algorithm of three identical PCRs. The Epi Info version 7 software was used for data analysis with a significance threshold of 5%. A total of 10,714 samples of infants and children born to HIV-positive mothers were analyzed by PCR. Ninety-six percent of mothers were on ARV prophylaxis (AZT 3TC NVP and AZT NVP) and 60% of newborns received the same ARV prophylaxis. Of these children, 956 tested positive with an overall transmission rate of 8.92%, varying between 7.27% in 2009 and 08.01% in 2018. This rate was relatively low among children receiving prophylaxis at 2.04% and remained high for children who received breastfeeding at 5.62%. However, the transmission rate remains low for those who have benefited from mixed and artificial breastfeeding at 1.58% and 1.27% respectively. A significant proportion of children remained infected by their mothers during pregnancy, childbirth or breastfeeding. This study shows the importance of early diagnosis of HIV in children using molecular technology.
文摘The emergence of antiretroviral resistance mutations represents a major threat to the achievement of national and global goals for the elimination of HIV-1 infection. The global strategy in 2019 in Cte d'Ivoire is a new national policy for the management of people living with HIV with the administration of dolutegravir (DTG)-based fixed-dose combination. The aim of our study was to evaluate HIV-1 resistance to antiretrovirals (ARVs) in infected adult subjects in Cte d’Ivoire in the context of a systematic switch to a DTG-based combination. Between February 2022 and October 2023, a cross-sectional survey with random sampling was conducted in 06 services caring for people living with HIV. A total of 139 participants were included in the study. Adults with a viral load ≥ 1000 copies/mL were tested for HIV-1 ARV resistance mutations. Molecular analyses were performed using protocol of ANRS-MIE (National Agency for Research on AIDS and emerging infectious diseases). The interpretation is performed by HIVGRAD (https://www.hiv-grade.de/cms/grade/). The frequencies of HIV-1 resistance to non-nucleotide reverse transcriptase inhibitors (NNRTIs), nucleotide reverse transcriptase inhibitors (NRTIs), integrase inhibitors (IINTs) and protease inhibitors (PIs) were 82%, 73%, 19% and 11% respectively. The main mutations observed in the different classes were K103N (45%), M184V (64%), E157Q (19%) and L10V/M46I/A71V/I54V (6%) respectively. This study reveals the emergence of resistance to DTG-based fixed-dose combinations, favored by high rates of resistance to NRTIs and NNRTIs. This finding underlines the need for enhanced viral load monitoring and HIV-1 genotyping tests to guide the choice of NRTIs for combination therapy. In addition, monitoring for mutations to second-generation NRTIs is essential, given the scale-up of DTG-based regimens currently underway in Cte d’Ivoire.
文摘Introduction: HIV, the human immunodeficiency virus, is the etiological agent of acquired immunodeficiency syndrome (AIDS). The aim of this study was to assess the evolution of the viral load in patients under treatment. Methodology: This was a study carried out from July 2017 to June 2022 at the Point G University Hospital laboratory. The determination of the viral load of patients was carried out by PCR on the ABOTT M2000sp/rt platform. Results: A total of 129 patients infected with HIV-1, aged 19 to 72 years with a mean age of 40.05 years ± 10.71;all on antiretroviral chemotherapy. The female gender predominated among our patients. The most common treatment regimen was 2INTI + 1INNTI with 72.9% followed by 2INTI + 1INI with 13.2%. As for the combinations of molecules, the combination TDF + 3TC + EFV and TDF + 3TC + DTG predominated, respectively 65.1% and 13.2%. 89.9% of our patients had undetectable viremia after 12 months of treatment (p < 0.005) with an average viral load which had evolved from 681315.65 copies/ml ± 1616908.484 to M0 at 5742.36 copies /ml ± 35756.883 at M12 (p Conclusion: Generally speaking, antiretroviral treatment had contributed to controlling viral loads, however the therapeutic combination TDF + 3TC + DTG had made it possible to obtain more patients with undetectable viremia instead.
