目标:在广东省,已发现丙型肝炎病毒(HCV)赋予对直接作用的抗病毒药物(DAA)的抗性。在不同的高危人群中,很少有HCV亚型和HCV抗性相关替换(RAS)的研究。在这项研究中,我们的目的是确定高危人群中的亚型分布和RAS,包括吸毒者(DU),男男性行为者(MSM),女性性工作者(FSW),广东省(人口高度发达的省份)和男性性传播疾病(STD)患者。
方法:使用基于城市的抽样策略,1356个样本来自不同的群体。系统发育分析基于核心确定的亚型,NS5B,或NS5A序列。分析不同风险组及区域的HCV亚型分布及RAS。
结果:十个亚型,其中6h和6k在广东小说,已确定。所有风险组中的主要亚型为6a。1b和3a中的RAS与其他研究中观察到的不同。粤西地区3b亚型高于其他三个地区。在6a或任何其他基因型6中未发现RAS。
结论:广东省高危人群中HCV亚型正在扩大。其他风险群体的药物使用和DU的商业性行为可能会将6a从DU传播到其他人群。1b和3a的RAS谱与在中国西南部进行的研究中报道的不同。需要进一步的研究来确定这种差异的原因。此外,在3b亚型中,RAS的组合较高。为指导HCV3b亚型的治疗,在不久的将来,西方城市应考虑HCV基因型3的预处理亚型。
OBJECTIVE: In
Guangdong Province, hepatitis C virus (HCV) had been found to confer resistance to direct-acting antivirals (DAAs). There were few studies of HCV subtypes and resistance-associated substitutions (RASs) of HCV in different high-risk populations. In this study, we aimed to determine the subtype distribution and the RASs in high-risk population groups, including drug users (DU), men who have sex with men (MSM), female sex workers (FSW), and male patients with sexually transmitted diseases (STD) in
Guangdong Province (a highly developed province with a large population).
METHODS: Using a city-based sampling strategy,1356 samples were obtained from different population groups. Phylogenetic analyses determined subtypes based on Core, NS5B, or NS5A sequences. HCV subtype distribution and RASs in various risk groups and regions were analyzed.
RESULTS: Ten subtypes, of which 6 h and 6 k were novel in
Guangdong, were identified. The primary subtype among all risk groups was 6a. RASs in 1b and 3a were different from those observed in other studies. Subtype 3b in western
Guangdong was higher than the other three regions. No RASs were found in 6a or any other genotype 6.
CONCLUSIONS: The HCV subtypes are expanding in high-risk populations in
Guangdong. Drug use by other risk groups and commercial sex by DU may bridge the dissemination of 6a from DU to other populations. The RAS profiles of 1b and 3a differed from those reported in studies conducted in southwestern China. Further research is required to determine the reason for this discrepancy. Moreover, the combination of RASs was high in subtype 3b. To guide HCV treatment of subtype 3b, pretreatment subtyping of HCV genotype 3 should be considered in western cities in the near future.