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目的分析宜宾市2014年检测的HIV-1抗病毒治疗半年以上患者的耐药情况,为下一步抗病毒治疗提供依据。方法对宜宾市艾滋病抗病毒治疗半年以上的患者进行病毒载量检测,对病毒载量结果大于1 000 cps/ml的患者样本的核酸进行PCR和pol基因测序,所得结果登录美国斯坦福大学HIV耐药数据库进行在线分析确定耐药突变情况。结果447例治疗患者中186例(41.61%)小于病毒载量最低检测限,147例(32.89%)病毒载量结果大于1 000 cps/ml,47例(10.51%)出现不同程度耐药,其中有1例NRTIs出现不同程度耐药,12例NNRTIs出现不同程度耐药,34例对NRTIs和NNRTIs同时出现不同程度耐药(有2例对NRTIs、NNRTIs以及PIs同时耐药)。47例产生耐药的患者中,28例(59.58%)CRF_01AE亚型,7例(14.89%)CRF_08BC亚型,7例(14.89%)CRF_07BC亚型,2例(4.26%)C亚型,剩余3例(6.38%)分型情况不详。结论宜宾市HIV耐药毒株呈现中度流行态势,已出现耐药情况的患者中,交叉耐药的情况比较普遍,尤其是对NNRTIs的交叉耐药比较严重,部分患者对NRTIs和NNRTIs全部耐药,建议临床医生加强对患者服药督导,提高患者的依从性,并根据耐药情况酌情对患者调整治疗方案。
Objective To analyze the drug resistance of HIV-1 virus tested in 2014 in Yibin City for more than six months and provide basis for further antiviral therapy. Methods The viral load was detected in patients with anti-virus therapy in Yibin for more than six months. PCR and pol gene sequencing were performed on the samples of patients with viral load greater than 1 000 cps / ml. The results were registered in Stanford University, Databases were analyzed online to identify resistance mutations. Results Of the 447 treated patients, 186 (41.61%) were less than the lowest detection limit of viral load, 147 (32.89%) had viral load greater than 1 000 cps / ml and 47 (10.51%) showed varying degrees of resistance One case of NRTIs showed different degrees of resistance, 12 cases of NNRTIs showed different degrees of resistance, and 34 cases showed resistance to both NRTIs and NNRTIs to varying extents (2 cases were resistant to NRTIs, NNRTIs and PIs). Of the 47 patients who developed resistance, 28 (59.58%) CRF_01AE subtypes, 7 (14.89%) CRF_08BC subtypes, 7 (14.89%) CRF_07BC subtypes and 2 (4.26% Three cases (6.38%) typing unknown. CONCLUSIONS: HIV-resistant strains of Yibin have a moderate prevalence. Among those who have developed drug resistance, cross-resistance is more common, especially for NNRTIs, and some patients are resistant to NRTIs and NNRTIs Drugs, it is recommended clinicians to strengthen supervision of patients taking medication to improve patient compliance, and according to the drug resistance, as appropriate, adjust the treatment of patients.