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目的了解绍兴市抗病毒治疗患者的耐药基因变异情况,以进一步指导抗病毒药物的选择。方法分析2013年7月-2014年5月绍兴地区抗病毒治疗大于1年且病毒未抑制的36例感染者样本,采用RT-PCR和nest-PCR方法扩增HIV-1的pol基因区全长,参照美国斯坦福大学HIV耐药数据库,确定HIV亚型及耐药突变位点。结果病毒耐药率为6.85%(33/482),33例病毒未抑制感染者样品检测到耐药突变,主要亚型为CRF01_AE和CRF07_BC。检测到针对核苷类逆转录酶抑制剂(NRTIs)的耐药突变,主要类型有M184V、K70R、D67N,针对非核苷类逆转录酶抑制剂(NNRTIs)耐药的突变,主要类型有V179D/E/T、K103N、Y181CY、V90I、G190A。结论绍兴市HIV经抗病毒治疗后易产生耐药性,应加强对HIV耐药变异监测和患者服药依从性干预。
Objective To understand the variation of drug resistance genes in patients with antiviral therapy in Shaoxing City to further guide the choice of antiviral drugs. Methods From July 2013 to May 2014, 36 HIV-infected patients with antiviral therapy over 1 year in Shaoxing and without virus suppression were enrolled. The full-length pol gene region of HIV-1 was amplified by RT-PCR and nest-PCR , Reference to the United States Stanford University HIV drug resistance database to determine the HIV subtypes and drug-resistant mutation sites. Results The rate of virus resistance was 6.85% (33/482). The resistant mutations were detected in 33 samples without infection. The major subtypes were CRF01_AE and CRF07_BC. Mutations were detected in nucleoside reverse transcriptase inhibitors (NRTIs). The main types of mutations were M184V, K70R and D67N, and mutations resistant to non-nucleoside reverse transcriptase inhibitors (NNRTIs). The main types of mutations were V179D / E / T, K103N, Y181CY, V90I, G190A. Conclusion HIV in Shaoxing is easy to develop resistance after antiviral therapy. Surveillance on HIV resistance variation and adherence to medication should be strengthened.