论文部分内容阅读
目的了解浙江省抗病毒治疗患者HIV-1毒株耐药性及其影响因素。方法选择杭州市、宁波市、温州市为研究现场,以2009年底仍在抗病毒治疗且年满18岁的AIDS患者为研究对象,进行问卷调查和血液采集。对病毒载量>1000 IU/ml的样本进行RT-PCR和巢式PCR扩增并测序,使用斯坦福大学HIVdb程序分析得到基因耐药结果。结果共273名研究对象纳入本研究分析。HIV-1毒株总耐药率为7.7%。职业为“其他”者、文化程度高者是预防耐药发生的保护性因素(OR=0.167、0.181),未婚或离异丧偶、治疗方案为D4T+DDI+NVP是耐药发生的危险性因素(OR=4.071、7.467)。结论浙江省抗病毒治疗患者耐药率处于低水平,但耐药突变多样化,应多关注文化程度低和无配偶者,尽早更改或停用D4T+DDI+NVP治疗方案,保持或提高服药依从性,可能有利于降低耐药毒株的发生。
Objective To understand the drug resistance and its influencing factors of HIV-1 strains in patients with antiviral therapy in Zhejiang Province. Methods Hangzhou, Ningbo and Wenzhou were selected as research sites. AIDS patients aged 18 and over who were still under antiviral treatment at the end of 2009 were selected as the research subjects for questionnaire survey and blood collection. RT-PCR and nested PCR were performed on samples with a viral load of> 1000 IU / ml and sequenced. Stanford University’s HIVdb program was used to analyze gene resistance results. Results A total of 273 subjects were included in this study. The total drug resistance rate of HIV-1 strain was 7.7%. Occupational as “other”, those with higher education level were the protective factor to prevent the emergence of resistance (OR = 0.167,0.181), unmarried or divorced widowed, the treatment plan was D4T + DDI + NVP was the risk of drug resistance Factors (OR = 4.071, 7.467). Conclusions In Zhejiang Province, the anti-virus drug resistance rate is low, but the drug-resistant mutations are diversified. More attention should be paid to those with low education level and no spouse. The D4T + DDI + NVP regimen should be changed or discontinued as soon as possible to maintain or improve compliance It may be beneficial to reduce the occurrence of drug-resistant strains.