Research On Genotype Sub-distribution Of HIV And Drug Resistance Among Newly Reported HIV-1 Positive Group In Longchuan County In 2017

Objective:The research is aimed for understanding the features of HIV-1 genotype sub-distribution among HIV positive group from the newly released report in Longchuan County,De hong Prefecture in 2017.Based on that,the paper makes it clear of the HIV-1 propagation rules and trends.Besides,by understanding the state of popular recombination and the level of genovariation,the study provides the theoretical basis for the study of board-crossing transmission,analyzing HIV-1 dynamically changing process and making related strategies of prevention&control.What’s more,the paper offers the scientific basis for antiviral treatment programs by revealing the situation of primary drug-resistance of the HIV-1 people who did not take related treatment from the newly released report in 2017 and gasping the relationship between HIV-1 subtype and drug resistance.Methods:By adopting the cross-sectional survey methodology,the thesis had the research epidemiological on the HIV-1 positive groups from Longchuan County which was newly released in the report of 2017.The procedure went as followed steps:Collecting blood samples;Separating plasma and extracting the nucleic acid;Amplifying the genetic fragment HIV-1 5’LRT-pol by using RT-PCR and Nested-PCR;Getting the amplified gene sequence fragment tested by Qingke Biological Sequencing Company;Getting the sequence of the testing result jointed and conducted by using SeqMan of Lasergene software;Combing the amplified sequence results with the reference sequence of genetic subtype data downloaded from the Los Alamos Lab,and comparing two parts above via the online tools;Adopting the MEGA software to access the Maximum Likelihood to building the phylogenetic tree;Using the SimPlot Software to have the recombining analysis on the possible genetic sequence;Uploading the 5’lRT-pol sequence to the database of Stanford University to analyze the drug resistance;Analyzing the epidemiological features and data of molecular epidemiology based on the newly report of HIV-1 positive group in Longchuan County in 2017.Results:1.Among 156 HIV-1 positive examples from 2017 newly report in Longchuan County,the result in the aspect of demography shows as below:Ration of women to men is 2.9:1.0（116 malse:40 females）,with average age of 33.3±11.1,and is mainly for the 20-30 years old（41.03%）,Jingpo Ethnic Minority（39.10%）,the married（52.56%）,the illiterate（63.46%）and the heterosexual transmission（67.31%）.The average cell count of CD4 after the first confirmation diagnosis is for 392.4±1255.5/mm3.Among the 156 HIV-1 positive cases in the newly report of 2017,there are 53（33.97%）Chinese and 103（66.03%）Burmese.And the features of cases above shows as below:they are mainly for males,peasants.Among the cases for Chinese,the average age is 39.6±13.4,mainly for De’ ang Ethnic Minority（47.17%）,the married（69.81%）、with educational background of primary school（43.40%）and the heterosexual transmission（55.34%）.2.Among the 110 effective 5’LRT-pol gene sequences gained from this research,there are over 10 HIV-1 genotypes which include 2 subtypes,10 CRFs and 3 different URFs.For the genotypes above,URF is the top list by taking 52.73%,then it follows as the order below:CRF01_AE（16.36%）,B subtype（7.27%）,C subtype（6.36%）、CRF62_BC（3.64%）、、CRF87_cpx（1.82%）、CRF07_BC（0.91%）、CRF55₀1B（0.91%）、CRF64_BC（0.91%）、CRF65_cpx（0.91%）、CRF96_cpx（0.91%）.3.Among 110 gene sequences,the amplification and test for the Chinese managed to amount for 35 samples,and URFs makes itself on the top list by taking 28.57%.Then it follows the CRF0_AE by taking 20.00%.The amplification and test for the Burmese managed to amount for 75 samples,and URFs makes itself on the top list by taking 64.00%.Then it follows the CRF₀1AE（14.67%）.4.Based on the analysis on the data in the aspect of demographic characteristics,it shows the features as followed:The risk for female infects CRF01_AE is 5.27 times（P<0.05）of male,the married for infects CRF01_AE is 0.17 times of the unmarried（P<0.05）,Burmese HIV-1 positive people is 3.03times（P<0.05）of infecting URF for Chinese HIV-1 positive people.The heterosexual transmission is 0.28 times（P<0.05）of infecting URF over transmission by drug using or inj ecting.5.Among 110 gene sequences,10 gene sequences show different drug resistance for three types of antiviral drugs（NRTIs、PIs、NNRTIs）and the rate of resistance is 9.09%.The rate of resistance for Burmese is10.67%,and 5.71%for Chinese.Among 10 cases of HIV/AIDS,there cases show the high rate of drug assistance,1 case for low moderate drug resistance and other cases for low rate of drug resistance.6.The research finds five genotypes（including URF、CRF08_BC、CRF57_BC、CRF01_AE、C）containing drug-resistance strains,and three samples with high drug resistance are URF genotype of Burmese cases.The rate for drug resistance of HIV-1 follows as listed:CRF08_BC 25.00%（1/4）、CRF57_BC 25.00%（1/4）、C subtype 14.29%（1/7）、URF 10.34%（6/58）.Conclusion:According to the newly report for HIV-1 positive people in 2017,cases are mainly featured as below:Burmese,infection of heterosexual transmission;varied and complicated HIV-1 genotypes（over 10 HIV-1 genotypes are identified,which includes 2 subtypes,10 CRFs and 3 types of URFs;And URF is identified as taking the largest portion）;According to the multivariate analysis in the aspect of demographic characteristics,the Burmese,adopting drug injection,carries the higher risk of infecting HIV-1 positive with URF,so it is necessary to strengthen monitoring and grasp the dynamic state of HIV-1 genotypes for Burmese and drug-injection groups.The genotype of Longchuan County is mainly featured with unknown and unique recombination.The study of revolution and recombination for 110 genetic sequences in Longchuan shows as followed:58 sequences are neither gathered with the known ones nor share the same recombination structure with them;And for those 58 sequences mentioned above,35 have identical sequences（≥2）with the BC reference sequence,which is the potentially new CRFs sequence,Subsequent amplification of full genetic verification is required.Longchuan County is the moderately popular area for primary drug-resistance of HI V-1.And the cases there show different level of drug resistance to three types of antiviral drugs（including NRTIs、PIs and NNRTIs）:mainly for low level of drug resistance,while the cases for high and moderate level of drug resistance also exist（all indicated from Burmese cases）.Based on the finding above,it is necessary to strengthen monitoring and grasp the sate of drug resistance of this area,especially for Burmese cases.Different types of mutation show varied drug resistance.The study showed that five types of HIV-1 genotypes（URF、CRF08-BC、CRF57-BC、CRF01_AE、C）produce the drug resistance strains.And the drug resistance detection rate for five types are respectively as following:CRF08_BC、CRF57_BC、C、URF.