| Background:AIDS (acquired immunodeficiency syndrome) is one of ten fatal diseases in the world, which seriously threaten the people’s life and health. There are more people infected human immunodeficiency virus-1 in Henan province than other areas, and the population diagnosed with this disease is the top three in our country. The paid blood donation is the major route of transmission in the last century, and the subtypes are mostly B and B’. In recent years, the routes of transmission are multiple, changing from blood transmission to maternal-neonatal transmission, sexual transmission and so on. In these types, the proportion of spreading through sex intercourse is bigger than others, and the number of men who have sex with men diagnosed with HIV-1 is most obviously increased. There are more probabilities to infect HIV-1 through this type because of the special behaviors in MSM, so we have to pay much attention to the MSM who have infected HIV-1 in Zhengzhou.Object:To investigate the subtype distribution and analyse drug resistance of human immunodeficiency virus-1 (HIV-1) infection among men who have sex with men (MSM) in Zhengzhou, Henan province. The origin of HIV-1 strains and the route of transmission were analyzed, providing for the clinical drug therapy of HIV-1 infection among MSM.Methods:Forty blood samples were collected from HIV-1 carriers, who acknowledged having sex with men. The number of CD4+T lymphocyte was measured within 48 hours. Then the blood was centrifuged, and the viruse load of plasma was detected. The gag, pol and gp41 genes were amplified by RT-PCR and nested-PCR. and sequenced. Some of the gag gene were cloned and sequenced. The quality of sequences was evaluated by Chromas software. All sequences were edited by BioEdit, and subtypes were analysed by genotyping software. Phylogenetic analyses of gag, pol and gp41 gene were then performed using the MEGA 3.1 software, and the gene distances were calculated by Distance program. The genetic subtypes were confirmed based on the results of gag, pol and gp41. Drug resistance mutations were analysed using HIV drug resistance database program of Stanford University.Results:1. Correlation analysis showed that there was negative correlation between the numbers of CD4+T lymphocyte and viruse load. The number of CD4 T lymphocyte and viruse load were from non-treatmented HIV-1 infection among MSM.2. Twenty-four gene sequences of gag, twenty-two gene sequences of pol and eighteen gene sequences of gp41 have been gotten. Based on the subtype results of three structural genes, it has been identified that there were four different HIV-1 subtyes including B, CRF01-AE, CRF07-BC and 01B present among MSM in Zhengzhou.3. The drug resistance analysis showed that there were not drug resistance mutations among un-treated HIV-1, while there were drug resistance mutations among treated HIV-1.Two samples showed low-level drug resistance to nelfinavir (NFV) which is part of protease inhibitors (Pls). One samples showed high-level drug resistance to efavirenz (EFV) and nevirapine (NVP) which are part of non-nucleoside reverse transcriptase inhibitors (NNRTIs). There were not drug resistance mutations to nucleoside reverse transcriptase inhibitors (NRTIs).Conclusions:1. Among un-treated HIV-1 infection from MSM of Zhengzhou, there was negative correlation between the number of CD4+T lymphocyte and viruse load.2. Epidemiological study of small number sample showed that there were four different HIV-1 subtyes including B,CRF01-AE, CRF07-BC and 01B present among MSM in Zhengzhou. Recombinant HIV-1 strains are circulating in Henan province.3. Among un-treated MSM in Zhengzhou, all samples displayed susceptible to both protease inhibitors and reverse transcriptase inhibitors.4. Among treated MSM in Zhengzhou, there is low-level drug resistance to NFV in two samples. At the same time, there is high-level drug resistance to EFV and NVP in one sample. All samples displayed susceptible to NRTIs. |
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