【摘要】 目的了解艾滋病病毒(HIV)抗病毒治疗停药患者病毒载量水平和耐药情况。方法对河南、湖南、广西、重庆、四川和云南共6个省份的HIV抗病毒治疗停药患者进行横断面抽样调查,收集调查对象社会人口学、治疗情况等数据,采集血液标本进行病毒载量检测,并对病毒载量≥1 000拷贝/m L的样本进行耐药基因检测。结果共调查467例患者,其中72.2%(337例)患者的病毒载量≥1 000拷贝/mL,测序获得336份序列进行耐药分析,19.3%(65/336)患者检出耐药。对核苷类反转录酶抑制剂、非核苷类反转录酶抑制剂和蛋白酶抑制剂的耐药率分别为4.6%(3/65)、87.8%(57/65)和10.8%(7/65)。未婚患者的耐药率要高于在婚的患者(P=0.003)。随着停药时间的增加,病毒载量≥1 000拷贝/mL的比例在上升,而耐药的比例在下降。结论 HIV抗病毒治疗停药人群病毒载量和耐药率均较高,是HIV病毒包括耐药株传播的重要来源。需对该人群加强预防干预,阻断HIV及耐药株的二代传播。更多还原

【Abstract】 Objective To investigate the viral loads and the prevalence of drug resistance in HIV/AIDS patients who had stopped antiretroviral therapy(ART) in 2016. Methods A cross-sectional survey was conducted among the HIV/AIDS patients who had stopped antiretroviral therapy in 2016. The blood samples were collected and HIV-1 viral load was detected. The samples with viral loads exceeded 1 000 copies/mL were amplified and sequenced for drug resistance analysis.The associate factors were analyzed by non-conditional logistic regression model. Results Of the 467 HIV/AIDS patients who had stopped ART, 337(72.2%) cases ’ viral loads were higher than 1 000 copies/mL. Among 336 samples which were successfully amplified and sequenced, 65 individuals showed resistance to nucleoside reverse transcriptase inhibitors, nonnucleoside reverse transcriptase inhibitors and protease inhibitors, with the drug resistance rates of 4.6%( 3/65), 87.8%(57/65) and 10.8%(7/65), respectively. Logistic regression analysis showed that factor significantly associated with STIs drug resistance was marital status(P=0.003). With the increase of stopping time, the proportion of viral load≥ 1 000 copies/mL increased and the drug resistance rate decreased. Conclusion HIV/AIDS patients who had stopped antiretroviral therapy in our research had high viral loads and drug resistance rate. We suggest that the management and interventions of those people should be strengthened to control the transmission of HIV, especially HIV resistant strain.更多还原