【作者】 于国龙； 鄢心革； 秦冰； 李杰； 刁丽梅； 况轶群； 付笑冰； 颜瑾； 林鹏；

【Author】 Yu Guolong 1 Yan Xinge 1 Qin Bing 2 Li Jie 1 Diao Limei 1 Kuang Yiqun 3 Fu Xiaoping1 Yan Jin 1 Lin Peng 1。 1.Centre for disease control and prevention of Guangdong province, Guangzhou 511430;2.Guangdong provincial of institute of biological products and materia and medicaGuangzhou 510440; 3.The institute of public health of Guangdong province, Guangzhou 511430, China

【机构】 广东省疾病预防控制中心艾滋病防治研究所； 广东省生物制品与药品研究所； 广东省公共卫生研究院；

【摘要】 目的:了解广东省艾滋病长期抗病毒治疗病人耐药情况。方法:对接受HAART治疗方案4年以上、病毒载量大于1000拷贝/ml艾滋病病人,进行HIV-1耐药基因型检测。采用In-House方法,扩增HIV-l的POL基因蛋白酶区(PR)基因全长和逆转录酶区(RT)基因部分片段,通过HIV-1耐药数据库(Stanford HIV-1Drug Resistance Database),获得个体耐药突变位点及药物耐受情况。结果:该人群HIV-1病毒未抑制率为:18.3%(22/120);基因型高度耐药病例12人,高度耐药比例为10%,RT区常见耐药突变:Y181C、G190A、K101Q/E/N、M184IMV和K219KR,PR区未见主要耐药突变;常用非核苷类逆转录酶抑制剂奈韦拉平(NVP),依非韦伦(EFV)耐药率分别为100%,92%;核苷类逆转录酶抑制剂拉米夫定(3TC)、恩曲他滨(FTC)、阿巴卡韦(ABC)的耐药率分别为83%、83%和42%。结论:长期治疗人群中高度耐药个体已超过10%,未发现蛋白酶区耐药病例,核苷类和非核苷类逆转录酶抑制剂均出现高度耐药病例。更多还原

【Abstract】 Objectives: To find the HIV-1 drug resistance prevalence in AIDS patients with HAART therapy over four years. Methods: Recruited the HIV/AIDS patients with HAART for more than four years, counted CD4+ T lymphocyte and HIV-1 viral load;and then detected the genotype drug resistance when the samples with virus load more than 1000 copies/ml by the IN-house method. Firstly amplified the whole genome of HIV-1 protease and part of reverse transcriptase genome, secondly sequenced the PCR products, and then assembled the sequence. Blast the sequence with the Stanford HIV-1Drug Resistance Database and get the drug resistance mutation and drug resistance. Results: CD4+ T Lymphocytes partly reconverted again and the virus load uncontrolled is 18.3%;about 10% patients (12 patients) were with high genotypic resistance. Major drug resistance mutations in RT region are as follows: Y181C、G190A、K101Q/E/N、M184IMV、K219KR. No major mutation was found in PI region. The NNTRI drug resistance is 100%, 92% to NVP and EFV respectively. The NTRI Drug resistance to 3TC、FTC and ABC is 83%, 83% and 42% respectively. Conclusion: HIV-1 drug resistance in therapy patients for long time was already more than 10 percent in Guangdong province. Viruses with high drug resistance to NNTRI and NTRI were found in this population, and more measure should be done in these people.更多还原