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目的通过对艾滋病抗病毒治疗失败人群(治疗后血浆HIV-1病毒载量≥1 000拷贝/ml)进行病毒基因型耐药研究,观察治疗1年后病毒抑制效果和耐药性产生情况。方法采用核酸序列依赖性技术提取核酸,Inhouse方法进行巢式PCR扩增,对扩增产物进行序列测定,应用美国斯坦福大学HIV耐药数据库进行耐药分析。结果 2013年和2014年接受抗病毒治疗人群中病毒载量≥1 000拷贝/ml血浆样本116例和213例中,耐药发生率分别为37.1%(43/116)和41.3%(88/213),两年核苷类逆转录酶区耐药位点以M184V/IV等位点为主,非核苷类逆转录酶区耐药位点有G190G/AG/GS和V179D/E/DE/DV 2项突变,未发现蛋白酶区主要耐药位点。结论多数经过抗病毒治疗的艾滋病病人机体免疫功能逐步恢复,体内病毒得到有效抑制。但是随着治疗时间延长,病毒发生突变也随之增多。因此在保证抗病毒治疗效果的前提下,采取减少耐药毒株发生措施尤为重要。
Objective To study the virus genotypes in HIV-1-infected patients (plasma HIV-1 viral load≥1 000 copies / ml after treatment), and to observe the effect of virus suppression and drug resistance after 1 year of treatment. Methods Nucleic acid was extracted by nucleic acid sequence-dependent technique. Inhouse method was used for nested PCR amplification. The amplified products were sequenced and analyzed by drug resistance database of Stanford University. Results In 116 and 213 cases of viral load≥1 000 copies / ml in 2013 and 2014, the incidence of drug resistance was 37.1% (43/116) and 41.3% (88/213) in patients receiving antiretroviral therapy ), Two years of nucleoside reverse transcriptase resistance sites to M184V / IV isolates, non-nucleoside reverse transcriptase resistance sites G190G / AG / GS and V179D / E / DE / DV Two mutations, no protease region found major resistance sites. Conclusion Most of the AIDS patients after antiviral treatment gradually recover the immune function, and the virus in the body is effectively inhibited. However, with the extension of treatment time, the mutation of the virus also increases. Therefore, to ensure the effectiveness of antiviral therapy under the premise of taking measures to reduce the occurrence of drug-resistant strains is particularly important.