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目的了解广州市外籍人类免疫缺陷病毒Ⅰ型(HIV-1)抗体阳性者中,耐药毒株的流行情况。方法应用巢式聚合酶链反应(PCR)方法,从广州市2008-2010年新确证的外籍HIV-1抗体阳性样本中,扩增蛋白酶(PR)和反转录酶(RT)基因序列,并与斯坦福耐药数据库比对,辨别耐药突变位点,分析耐药性。结果共获得90例外籍HIV-1抗体阳性者的PR和RT序列,耐药率为23.33%(21/90),其中对蛋白酶抑制剂(PIs)耐药率为15.56%(14/90),且集中表现为对NFV/r耐药,对核苷类反转录酶抑制剂(NRTIs)耐药率为6.67%(6/90),对非核苷类反转录酶抑制剂(NNRTIs)耐药率为5.56%(5/90);发现1例对除DRV/r外的所有其他PIs耐药,4例对所有NNRTIs耐药,2例对所有NRTIs耐药;发生频率较高的突变是L10I/V和K20I。结论广州市外籍HIV-1抗体阳性病例中存在耐药株的流行,尤其是耐多药毒株的存在,增加了广州市耐药毒株传播的风险。
Objective To understand the prevalence of drug-resistant strains in HIV-1 antibody positive individuals in Guangzhou. Methods The nested polymerase chain reaction (PCR) method was used to amplify the protease (PR) and reverse transcriptase (RT) gene sequences from newly confirmed foreign HIV-1 antibody positive samples from 2008 to 2010 in Guangzhou City. Compare with Stanford drug resistance database, identify drug-resistant mutation sites and analyze drug resistance. Results The PR and RT sequences of 90 HIV-1 positive individuals were obtained. The resistance rate was 23.33% (21/90). The resistance rate to protease inhibitors (PIs) was 15.56% (14/90) And showed resistance to NFV / r, resistance rate to nucleoside reverse transcriptase inhibitors (NRTIs) was 6.67% (6/90), resistance to nonnucleoside reverse transcriptase inhibitors (NNRTIs) The drug resistance was 5.56% (5/90). One patient was found to be resistant to all other PIs except DRV / r, four were resistant to all NNRTIs and two were resistant to all NRTIs; the higher frequency of mutation was L10I / V and K20I. Conclusions The prevalence of drug-resistant strains in HIV-1 antibody positive cases in Guangzhou city exists, especially the presence of multi-drug resistant strains, which increases the risk of transmission of drug-resistant strains in Guangzhou.