不同感染途径HIV患者治疗后的耐药突变及影响因素分析

发布时间：2018-09-08 11:34

【摘要】：目的分析河北省不同感染途径的HIV患者治疗后基因突变情况及其相关影响因素。方法采集正在接受抗病毒治疗的HIV患者血浆,采用基因型检测法检测HIV-1 pol区突变基因并分析其耐药性。结果 266例患者中157例发生了基因突变,耐药发生率59.0%。266例患者中高度耐药发生率为NVP 65.8%(175/266)、3TC 41.7%(111/266)、F TC 4 1.7%(1 1 1/2 6 6)、E F V 3 0.1%(8 0/2 6 6)、D D I 5.6%(1 5/2 6 6)、D 4 T 4.1%(1 1/2 6 6)、A ZT 3.0%(8/2 6 6)、A B C3.0%(8/266)。经血感染的HIV患者耐药发生率高于性途径和母婴途径,但χ2检验结果显示这3种途径之间在NNRTIs编码区Y181C、K103N、V108I、K101E等主要突变位点(χ2=4.796,P=0.531),NRTIs编码区M184V/I、M41L、T215F、T215Y(χ2=5.261,P=0.511),PIs编码区A71V/T、L10I、M46L、Q58E(χ2=6.150,P=0.407)的差异均无统计学意义。OR值计算和95%CI分析表明,患者年龄、感染途径、CD4+T淋巴细胞数、初始治疗方案与HIV-1耐药突变的发生存在显著相关性(P0.05)。结论在HIV治疗过程中应适时进行CD4+T淋巴细胞、病毒载量和耐药监测,评估疾病进程,使引起耐药的相关因素的影响降到最低,并及时更新治疗方案。
[Abstract]:Objective to analyze the gene mutation and its related factors in HIV patients with different infection pathways in Hebei province. Methods the plasma samples of HIV patients undergoing antiviral therapy were collected. The mutation gene of HIV-1 pol region was detected by genotypic detection and drug resistance was analyzed. Results there was a gene mutation in 157 of 266patients. The incidence of high drug resistance in 59.0.266 patients was: NVP 65.8% (175p 266) 3TC 41.7% (111266) F TC 41.7% (11 / 26) E F V 30.1% (8 026.6) D D I 5.6% (1.5 / 266) D 4 T 4.1% (1,126.6) A ZT 3.0% (82.6%) A / C 3.0% (8 / 266). The incidence of drug resistance in patients with HIV through blood infection was higher than that in sex and mother and child. 浣喯，

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