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目的了解福建省Ⅰ型艾滋病病毒(HIV-1)的耐药基因变异情况。方法选取2005-2012年福建省抗病毒治疗1年以上、病毒载量高于1 000拷贝/mL的HIV感染者/艾滋病病人标本,进行基因型耐药性检测。同时收集前期研究中的耐药性检测数据进行对比分析。结果共检测73例病毒学治疗失败病人标本,其中60例(82.19%)成功扩增序列,结合125份未接受抗病毒治疗者的样本,共获得185份样本进行耐药分析。未治疗组和治疗组对蛋白酶抑制剂(PI)的耐药发生率均较低,分别为1.60%(2/125)和8.33%(5/60);未治疗组对反转录酶抑制剂(RTI)的耐药发生率为4.80%(6/125);治疗组对RTI耐药发生率较高,为61.67%(37/60),尤其是对NVP、EFV、3TC和FTC。最常见的耐药突变有M184V、D67N、K70R、K219Q、T215F、G190A、Y181C和K103N。结论福建省HIV-1感染者的总体原发性耐药突变率较低,病毒学治疗失败病人对PI耐药发生率仍处于低水平,但对RTI耐药发生率较高。
Objective To understand the variation of drug resistance genes of HIV-1 in Fujian Province. Methods The HIV-infected / AIDS-infected patients with anti-viral treatment more than 1 year and viral load above 1 000 copies / mL in Fujian province from 2005 to 2012 were selected for genotypic drug resistance testing. In the meantime, the data of resistance test in previous studies were collected for comparative analysis. Results A total of 73 samples of patients with failed virological therapy were detected, of which 60 samples (82.19%) were successfully amplified. A total of 185 samples were obtained for resistance analysis in combination with 125 samples of patients who did not receive anti-virus therapy. The rates of resistance to protease inhibitor (PI) in the untreated and treated groups were all lower, 1.60% (2/125) and 8.33% (5/60), respectively. The untreated group had higher rates of reverse transcriptase inhibitor (RTI) was 4.80% (6/125). The treatment group had a higher incidence of RTI resistance (61.67%, 37/60), especially for NVP, EFV, 3TC and FTC. The most common resistance mutations are M184V, D67N, K70R, K219Q, T215F, G190A, Y181C and K103N. Conclusion The overall rate of primary drug-resistant mutations in HIV-1 infected patients is low in Fujian Province. The incidence of PI-resistant drug in patients with failed virological therapy is still low, but the rate of resistant to RTI is high.