四川省凉山州布拖县HIV-1耐药基因检测情况分析

发布时间：2018-06-03 21:08

本文选题：艾滋病毒 + 抗病毒治疗　；参考：《现代预防医学》2015年16期

【摘要】：目的了解凉山州布拖县艾滋病毒-I型(HIV-1)耐药基因突变情况,优化抗病毒治疗(ART)方案,提高治疗效果。方法采用反转录式聚合酶链反应(RT-PCR)方法,检测2008、2010、2012年三年ART后病毒学失败患者的HIV-1耐药基因型。结果截至2012年12月凉山州布拖县累计治疗艾滋病(AIDS)患者1 755人,检测HIV-1病毒载量(VL)1 324次人,HIV-1 VL50拷贝/ml者为25.4%(336/1 324),VL 51~1 000拷贝/ml者为16.3%(216/1 324),VL1 000拷贝/ml为58.3%(772/1 324),三年有218例进行了耐药基因突变检测,获得可用序列148例,其中未检出耐药突变者为42.6%(63/148),发生耐药突变者为57.4%(85/148)。非苷类反转录酶抑制剂(NNRTI),蛋白酶抑制剂(PI)和核苷和核苷酸类反转录酶抑制剂(NRTI)相关的耐药基因突变率分别为33.8%(50/148)、33.1%(49/148)、10.8%(16/148)。NNRTI相关的耐药基因突变位点前3位依次是K103N/KN(47.1%)、Y181C/CY(10.3%)、Y188FY/C/L/CY(10.3%)、G190AG/A(8.8%);PI相关的耐药基因突变位点前3位的是T71V/AT/AV(67.2%)、L10IL(20.0%)、L33IL(3.6%);NRTI相关的耐药基因突变位点前3位依次是M184V(33.3%)、T69N/S/AT(19.0%)、D67N(9.5%)、G333E(9.5%)。结论凉山州布拖县抗病毒治疗后病毒学失败患者中,以NNRTI耐药最多,其次为NRTI,PI较少,但PI是以次要位点(T71V/AT/AV)耐药突变较NRTI多。
[Abstract]:Objective to investigate the mutation of HIV-1 resistance gene in Butuo county of Liangshan state and to optimize the antiviral therapy regimen and to improve the therapeutic effect. Methods reverse transcriptase polymerase chain reaction (RT PCR) was used to detect the genotypes of HIV-1 resistance in patients with virological failure after ART in 2008 and 2012. Results as of December 2012, 1,755 patients had been treated with AIDS in Butuo County, Liangshan Prefecture. The total number of copies of HIV-1 virus detected was 25.4 times for HIV-1 VL50 copy / ml, and 336 / 1 / 1 324 / ml VL 51000 copy / ml was 16.316-1 / 1 324000 copies / ml for 58.3 / 772r-1 / ml, and 218 cases were tested for drug-resistance gene mutation in three years and 148 cases were obtained usable sequences. Among them, 42.6% of drug-resistant mutants were detected, and 57.4% of resistant mutants were found to be 85 / 148%. NNRTI, a non-glycoside reverse transcriptase inhibitor, a protease inhibitor (Pi), and a nucleotide reverse transcriptase inhibitor (NRTI), respectively, had mutations associated with the drug resistance gene of 33.880 / 1480.49 / 148i, 16 / 148r.NNRTI, respectively. The first three positions were K103NKN / 47.1C / Y 181C / CY10.3C / CY10.3P / CY10.3P / CY10.3P / CY10.3P / CY10.3P / CY10.3P / CY10.3P / CY10.3P / CY10.3P / CY10.3P / CY10.3P / CY10.3P / CY10.3P / CY10.3P / CY10.3P / CY10.3P / CY10.3P / CY10.3P / CY10.3P / CY10.3P / CY10.3P / CY10.3P / CY10.3P / CY10.3P The top three mutation loci of drug gene were T71V / ATR / AV77.2and L10ILT 20.0and L33ILT 3.60.The first three mutation sites associated with NRTI were M189V33.3N- / T69N-% AT19.0 D67N9.5T / T = G333Em9.50.The first three mutation sites were M1844 V 33.3N / T 19.0 D67N 9.5T and G333E9. 5 / 5 respectively, and the first three were M1844 V 33. 3N / T 19. 0% AT19. 0% AT19. 0 and 9. 5%. Conclusion in the patients with virology failure after antiviral therapy in Butuo County of Liangshan state, the drug resistance of NNRTI was the most, followed by less Pi of NRTI, but the resistance mutation of Pi was more than that of NRTI.
【作者单位】：布拖县人民医院抗病毒治疗中心;四川省疾病预防控制中心;布拖县疾病预防控制中心;
【基金】：国家十二五传染病重大专项(编号码:2009zx10004-905,2011zx10001-002)
【分类号】：R512.91

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