新余市CRF01-AE亚型人类免疫缺陷病毒的分子流行病学及其抗病毒治疗的研究

发布时间：2018-08-18 09:03

【摘要】：为了分析新余市HIV-1 CRF01-AE亚型的变异特征,了解其流行特性和最适抗逆转录病毒治疗方案,提高疗效,本文通过提取HIV毒株的RNA,巢式PCR扩增其env基因,产物经纯化测序,获得序列;对达到抗病毒治疗标准的HIV感染者,用不同治疗方案治疗至少6个月,并每隔3个月进行CD4+T淋巴细胞计数,获得治疗方案与疗效的关系。结果发现,经异性性接触感染的CRF01-AE亚型毒株间基因距离较大(0~47.4%),分为两大支,而同性性接触感染株较集中,基因距离小(0~2.6%);CRF01-AE亚型感染者合并乙肝、丙肝和梅毒感染率较高(56.3%);该型感染者经不同抗病毒治疗方案短期治疗后,CD4+T淋巴细胞水平都逐渐上升,但上升水平差异显著(p0.05)。可见,HIV-1 CRF01-AE亚型毒株在传播过程中产生了各自的变异特征,且在新余市成为优势株而不断扩散,其感染者合并其它病毒感染率高,机会性感染大。HIV-1 CRF01-AE亚型毒株对治疗方案具有选择性,临床尽量选择最佳治疗方案,少用方案AZT+NVP+3TC,以提高疗效,降低机会感染率。
[Abstract]:In order to analyze the variation characteristics of HIV-1 CRF01-AE subtype in Xinyu city, understand its epidemic characteristics and the most suitable antiretrovirus treatment scheme, and improve the curative effect, the env gene of HIV strain was amplified by nested PCR, and the product was purified and sequenced. Patients with HIV who met the standard of antiviral therapy were treated with different treatment regimens for at least 6 months and CD4 T lymphocytes were counted every 3 months to obtain the relationship between the treatment plan and the curative effect. The results showed that the CRF01-AE subtype infected by heterosexual contact had a larger gene distance (47.4%), which was divided into two branches, while the same sex contact infected strain was more concentrated, and the gene distance was small (0%). The infection rate of hepatitis C and syphilis was higher (56.3%), and the level of CD4 T lymphocytes increased gradually after short-term treatment with different antiviral therapy, but the difference was significant (p0.05). It can be seen that the HIV-1 CRF01-AE subtype strains have their own variation characteristics in the course of transmission, and become dominant strains and spread continuously in Xinyu city, and the infection rate of HIV-1 CRF01-AE subtype strains is high, and the infection rate of other viruses is high. The HIV-1 CRF01-AE subtype of opportunistic infection was selective to the treatment regimen. The best treatment regimen was chosen in clinic, and the AZT NVP 3TCwas less used to improve the therapeutic effect and reduce the opportunistic infection rate.
【作者单位】：新余市疾病预防控制中心;
【基金】：江西省性病艾滋病省市共建项目资助
【分类号】：R512.91

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