AIDS病人血浆和脑脊液中HIV-1病毒载量及耐药变异分析

发布时间：2019-02-16 07:51

【摘要】：目的分析艾滋病(AIDS)病人血浆与脑脊液中,艾滋病病毒I型(HIV-1)的病毒载量、基因耐药突变之间的关系。方法采集72例AIDS病人配对的血浆和脑脊液标本,检测HIV-1病毒载量,对接受抗病毒治疗(ART)超过48周、但病毒载量1000拷贝/mL的标本进行基因型耐药检测。结果 72例AIDS病人中,37例未接受ART,血浆和脑脊液的病毒载量分别为5.04(3.56~6.65)lg拷贝/mL和4.15(1.70~6.25)lg拷贝/mL,差异有统计学意义(Z=-3.314,P=0.001)。35名接受一线抗病毒药物治疗超过48周的病人,血浆和脑脊液中的病毒载量分别为1.69(1.69~6.49)lg拷贝/mL和1.70(1.70~4.34)lg拷贝/mL,两者差异无统计学意义(Z=-1.253,P=0.210)。治疗组与未治疗组病人血浆及配对脑脊液病毒载量之间均无显著相关性,治疗病人血浆和脑脊液中病毒载量检测结果不一致率为51.4%。产生耐药性是ART失败的一个主要原因,血浆和配对脑脊液中的耐药基因突变位点类型基本一致。结论未接受ART病人血浆中的HIV-1病毒载量高于脑脊液。ART失败的病人(接受治疗但血浆和/或脑脊液病毒载量仍50拷贝/mL)的血浆和脑脊液中,病毒载量检测结果存在较高的不一致率。ART失败外周血和中枢神经系统耐药突变基本一致。
[Abstract]:Objective to analyze the relationship between viral load and gene resistance mutation of HIV type I (HIV-1) in plasma and cerebrospinal fluid (CSF) of (AIDS) patients. Methods the plasma and cerebrospinal fluid (CSF) samples from 72 patients with AIDS were collected and the viral load of HIV-1 was detected. The genotypes of patients receiving antiviral therapy for (ART) more than 48 weeks but the viral load of 1000 copies / mL were tested for drug resistance. Results in 72 patients with AIDS, the viral load in plasma and cerebrospinal fluid of 37 patients without ART, were 5.04 (3.566.65) lg / mL and 4.15 (1.706.25) lg copy / mL, respectively. 35 patients receiving first-line antiviral therapy for more than 48 weeks had viral loads of 1.69 (1.690.49) lg / mL and 1.70 (1.704.34) lg copies / mL, in plasma and cerebrospinal fluid, respectively. There was no significant difference between the two groups. There was no significant correlation between plasma and matched CSF viral load in treatment group and untreated group. The inconsistent rate of viral load in plasma and cerebrospinal fluid was 51.4%. Drug resistance was a major cause of ART failure, and the type of mutation loci of drug resistance gene in plasma and matched cerebrospinal fluid (CSF) was basically the same. Conclusion the viral load of HIV-1 in plasma of patients without ART is higher than that of patients with cerebrospinal fluid. Patients with failed ART (50 copies / mL of plasma and / or CSF) failed to receive ART. The results of viral load detection showed high inconsistent rate. The mutation of drug resistance in peripheral blood and central nervous system (CNS) failed by ART was basically the same.
【作者单位】：首都医科大学附属北京佑安医院临检中心;首都医科大学附属北京佑安医院感染中心实验室;北京市肝病研究所;
【基金】：“十一五”国家科技重大专项课题(2012ZX10001002-002-011)~~
【分类号】：R512.91

【参考文献】