论文部分内容阅读
目的分析吉林市HIV感染者中HIV-1型对常用治疗药物的基因型耐药情况。方法采集吉林市接受抗病毒治疗的HIV-1感染者血样,提取RNA,采用巢式PCR法扩增HIV-1基因,利用ABI 3100测序仪进行核苷酸序列测定;用Sequencher 4.9对测定的序列拼接,用Bioedit软件进行多序列比对及序列清理后,与Stanford HIV Drug Resistance Database中的参考株序列进行比较,分析耐药基因突变及耐药结果。结果 49名HIV感染者中发现27人耐药,耐药率55.1%。检测出反转录酶(RT)区耐药突变位点8个,其中核苷类反转录酶抑制剂(nucleoside reverse transcripase inhibitors,NRTIs)类中,15例M184V和3例M41L突变,对应拉米夫定(Lamivudine,3TC)/恩曲他滨(Emdtricitabine,FTC)耐药15例和齐多夫定(Zidovudine,AZT)/司他夫定(Stavudine,D4T)耐药7例;非核苷类反转录酶抑制剂(non-nucleoside reverse transcripase inhibitors,NNRTIs)类中,13例K103N、8例V106I、6例Y181C及4例P225H突变,对应奈韦拉平(Nevirapine,NVP)耐药26例、依非韦伦(Efavirenz,EFV)耐药25例和利匹韦林(Rilpivirine RPV)耐药14例。蛋白酶(PR)区仅发现次要耐药突变(A71V/T/I和L10I/V),未造成相应药物的耐药。结论吉林市HIV感染者中耐药率较高,应加强耐药监测,拟定患者个性化治疗方案。
Objective To analyze the genotypes of HIV-1 in HIV-infected people in Jilin City. Methods Blood samples of HIV-1 infected patients receiving anti-virus treatment were collected, RNA was extracted, the HIV-1 gene was amplified by nested PCR, and the nucleotide sequence was determined by ABI 3100 sequencer. Sequences After stitching, multiple sequence alignments and sequence cleanup were performed with Bioedit software and compared with the reference strain sequences in the Stanford HIV Drug Resistance Database to analyze the resistance gene mutations and drug resistance results. Results Of the 49 HIV-infected patients, 27 were found to be drug-resistant with a resistance rate of 55.1%. Eight sites of resistance mutations were detected in reverse transcriptase (RT) region. Among them, 15 cases of M184V and 3 cases of M41L mutation in nucleoside reverse transcriptase inhibitors (NRTIs) 15 cases were resistant to Lamivudine (3TC) / Emtricitabine (FTC) and 7 cases were resistant to Zidovudine (AZT) / Stavudine (D4T). Non-nucleosides Thirteen patients with K103N, eight patients with V106I, six patients with Y181C and four patients with P225H mutation were resistant to Nevirapine (NVP) in 26 patients with non-nucleoside reverse translocase inhibitors (NNRTIs) 25 cases were resistant to Efavirenz (EFV) and 14 cases were resistant to Rilpivirine RPV. Protease (PR) region found only minor resistance mutations (A71V / T / I and L10I / V), did not cause the corresponding drug resistance. Conclusion There is a high resistance rate in HIV-infected persons in Jilin City. Drug-resistant surveillance should be strengthened to formulate personalized treatment plans for patients.