北京地区未经抗病毒治疗的HIV感染者HIV-1毒株耐药基因变异研究

发布时间：2018-03-07 14:55

本文选题：艾滋病　切入点：抗病毒治疗　出处：《中国艾滋病性病》2015年10期 　论文类型：期刊论文

【摘要】：目的观察北京地区未经抗病毒治疗的艾滋病病毒(HIV)感染者HIV-1毒株耐药基因的变异情况,用于指导临床用药。方法以2014年4-7月北京地区601例未经抗反转录病毒治疗的HIV感染者/艾滋病(AIDS)病人(简称HIV/AIDS病人)为对象。采集病人的静脉血,提取血浆病毒核糖核酸(RNA),用反转录/巢式聚合酶链式反应扩增病毒pol基因,并进行序列测定和亚型分析。在Stanford University HIV耐药数据库查询,分析是否存在基因型耐药以及耐药种类。结果 601例未经抗反转录病毒治疗的HIV/AIDS病人中,扩增成功的458例,其中男性434例(94.8%),女性24例(5.2%);平均年龄33岁(17~77岁)。主要感染亚型依次为CRF01_AE(211例,46.1%)、CRF07_BC(126例,27.5%)、B亚型(106例,23.1%)和C亚型(15例,3.3%)。在扩增成功的病人中,7.4%(34/458)的病人存在原发耐药基因变异,其中7例病人对核苷类反转录酶抑制剂(NRTIs)耐药,16例病人对非核苷类反转录酶抑制剂(NNRTIs)耐药,8例对蛋白酶抑制剂(PIs)耐药,3例病人同时对NRTIs和NNRTIs耐药。结论北京地区未经治疗的HIV/AIDS病人中,有部分病人存在原发耐药基因变异,极少数病人同时存在对两种主要治疗药物耐药,因此治疗前需要根据耐药检测结果制定用药方案,有助于提高治疗有效率,避免治疗失败。
[Abstract]:Objective to observe the variation of drug resistance gene of HIV-1 strain in HIV infected persons without antiviral therapy in Beijing area. Methods A total of 601 patients with HIV / AIDS-AIDS (HIV/AIDS) who were not treated with antiretrovirals from April to July in Beijing from 2014 to July were studied. The venous blood of the patients was collected. The viral pol gene was amplified by reverse transcription / nested polymerase chain reaction (RT-PCR), and sequenced and subtype analyzed. Results among the 601 HIV/AIDS patients who were not treated with antiretroviral therapy, 458 were amplified successfully. Among them, 434 cases were male and 24 cases were female. The average age was 33 years old and 1777 years old. The main subtypes of infection were CRF01_AE(211 (46.1%), CRF07BC126 cases (10.6 cases) and C subtype (15 cases). There was genetic variation of primary drug resistance in the patients with successful amplification. Among them, 7 cases were resistant to nucleoside reverse transcriptase inhibitor (NRTIs) and 16 cases were resistant to NNRT Is.Conclusion in Beijing area, both NRTIs and NNRTIs are resistant to both NRTIs and NNRTIs in 8 cases. Of untreated HIV/AIDS patients, Some patients have genetic variation of primary drug resistance, and a few patients have two main drug resistance. Therefore, it is necessary to make drug use plan according to the results of drug resistance test before treatment, which is helpful to improve the effective rate of treatment and avoid the failure of treatment.
【作者单位】：首都医科大学附属北京佑安医院;北京市疾病预防控制中心;首都医科大学附属北京地坛医院;
【基金】：国家自然科学基金(81273136) 北京市医院管理局临床医学发展专项经费资助(ZY201401)~~
【分类号】：R512.91

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