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目的了解2013年广西边境地区已接受高效抗反转录病毒治疗(HAART)的病人中,艾滋病病毒(HIV)的耐药情况。方法对防城港市、崇左市、南宁市2013年已接受HAART>1年的病人进行问卷调查,并检测HIV-1病毒载量,对病毒载量>1000拷贝/mL的样本进行自建耐药检测,登录美国斯坦福大学HIV耐药数据库,分析基因耐药结果。结果共1659例病人纳入研究分析,124例病毒载量结果大于1000拷贝/mL,其中100例样本核酸扩增阳性,59例出现不同程度的耐药突变;发现对核苷类反转录酶抑制剂(NRTIs)和非核苷类反转录酶抑制剂(NNRTIs)的最主要耐药突变位点,分别为M184I/V、K103N/S、Y181C/I/V和G190A/E,发现2例有蛋白酶类抑制剂(PIs)耐药突变。54例病人出现了耐药,其中41.0%(41/100)对NRTIs耐药,49.0%(49/100)对NNRTIs耐药,2.0%(2/100)对PIs低度耐药;32.0%(32/100)对NNRTIs和NRTIs双重耐药,1.0%(1/100)可能对三类药物耐药。HIV-1毒株在调查人群总耐药发生比例为3.3%(54/1659)。结论广西边境地区2013年已接受HAART人群中,HIV耐药株发生率较低,但耐药基因突变较为复杂,出现较多对NNRTIs和NRTIs双重耐药,以及可能对NRTIs、NNRTIs和PIs多重耐药,应采取科学合理治疗。
Objective To understand the prevalence of HIV in patients who have received highly active antiretroviral therapy (HAART) in the border area of Guangxi in 2013. Methods A questionnaire survey was conducted among patients in Fangchenggang City, Chongzuo City and Nanning City who had been receiving HAART> 1 year in 2013. HIV-1 viral load was also tested. Self-built drug resistance samples with viral load> 1000 copies / mL Detection, login at Stanford University HIV drug resistance database, analysis of gene resistance results. Results A total of 1659 patients were included in the study. The results of 124 viral loads were more than 1000 copies / mL. Among them, 100 samples showed positive amplification of nucleic acid and 59 cases showed different degrees of drug-resistance mutations. Nucleoside reverse transcriptase inhibition (NRTIs) and nonnucleoside reverse transcriptase inhibitors (NNRTIs) were M184I / V, K103N / S, Y181C / I / V and G190A / E respectively Protease inhibitors (PIs) drug-resistant mutations. Among the 54 patients, 41 (41/100) were resistant to NRTIs, 49.0% (49/100) were resistant to NNRTIs, 2.0% (2/100) were low resistant to PIs, 32.0% 32/100) are double resistant to NNRTIs and NRTIs, and 1.0% (1/100) may be resistant to the three classes of drugs. HIV-1 strains in the survey population total resistance was 3.3% (54/1659). Conclusions The prevalence of HIV-resistant strains was lower in HAART population in Guangxi border area in 2013, but the mutation of drug-resistant gene was more complicated. There were more double-drug resistance to NNRTIs and NRTIs, and more resistance to NRTIs, NNRTIs and PIs Medicine, should take scientific and rational treatment.