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目的调查福建省2013年未经抗病毒治疗的艾滋病病毒(human immunodeficiency virus,HIV)感染者的耐药株传播水平。方法根据HIV耐药警戒线实施方案,对2013年1~12月福建省新发现的HIV-1感染者的血浆样本进行HIV-1耐药基因型检测和耐药株传播水平分析。结果共有90例获得调查,47例样本完成了基因型和耐药鉴定。按pol区分型,主要为CRF01_AE和BC亚型,分别占51.06%(24/47)和34.04%(16/47),B亚型4例(8.51%),BD亚型和CD亚型、CRF01_AE/B各1例(2.13%)。共检测出2例耐药,核苷类反转录酶抑制剂耐药主要突变位点分别为T215S和T215F,可引起阿巴卡韦(ABC)、去羟肌苷(DDI)、替诺福韦(TDF)、齐多夫定(AZT)、司他夫定(D4T)不同水平耐药,其中1例还有非核苷类反转录酶抑制剂突变位点K103N、V108I,可引起依非韦伦(EFV)、奈韦拉平(NVP)高度耐药。结论本次调查显示福建省的耐药株流行率为4.26%,小于5%,属于HIV-1耐药株的低度流行水平。需在下一年继续监测,并加强规范艾滋病抗病毒治疗及科学管理。
Objective To investigate the transmission of drug-resistant strains of HIV-1-infected individuals without HIV in Fujian Province in 2013. Methods According to the implementation plan of HIV resistance warning line, the HIV-1 resistant genotypes and the transmission of drug-resistant strains of HIV-1 newly discovered in Fujian province from January to December 2013 were analyzed. Results A total of 90 cases were investigated, and 47 samples completed the genotype and drug resistance identification. According to the classification of pol, CRF01_AE and BC are the major subtypes, accounting for 51.06% (24/47) and 34.04% (16/47) respectively, 4 subtype B (8.51%), BD subtype and CD subtype, CRF01_AE / B in 1 case (2.13%). A total of 2 resistant and nucleoside reverse transcriptase inhibitors were detected. The main mutations were T215S and T215F, which could cause abacavir (ABC), didanosine (DDI), tenofovir (TDF), zidovudine (AZT), stavudine (D4T) at different levels of resistance, including 1 non-nucleoside reverse transcriptase inhibitor mutation sites K103N, V108I, can cause by non Velen (EFV) and nevirapine (NVP) are highly resistant. Conclusion The survey shows that the prevalence of drug-resistant strains in Fujian Province is 4.26%, less than 5%, which belongs to the low prevalence level of HIV-1 resistant strains. It is necessary to continue monitoring in the next year and to step up the regulation of AIDS antiviral treatment and scientific management.