【作者】 李韩平； 郭伟； 朱新鹏； 王哲； 刘永健； 鲍作义； 李林； 庄道民； 刘思扬； 王铮； 王晓林； 李敬云；

【Author】 LI Han-ping~(*1),Guo Wei~1,ZHU Xin-peng~2,Wang Zhe~2,LIU Yong-jian~1,BAO Zuo-yi~1,LI Lin~1,Zhuang Dao-min~1,Liu Si-yang~1,Wang Zheng~1,Wang Xiao-lin~1,LI Jing-yun~1 1 *The State Key Laboratory of Pathogen and Biosecurity,Institute of Microbiology and Epidemiology, Academy of Military Medical Science,Beijing 100071,China; 2 Henan Center for Disease Control and Prevention,Zhengzhou 450000,China

【机构】 军事医学科学院微生物流行病研究所病源微生物生物安全国家重点实验室； 河南省疾病预防控制中心；

【摘要】 目的了解河南省部分艾滋病患者抗病毒治疗效果及耐药发生情况,分析劣势耐药毒株在该人群本底存在情况。方法以河南某农村149名初始接受抗病毒治疗的艾滋病患者为研究对象,采用自建(In-house)基因型耐药检测方法分析抗病毒治疗失败患者HIV-1耐药发生情况,对抗病毒治疗后产生耐药的病例采用等位基因特异性实时定量ASPCR(Allele-specific real-time PCR)方法检测其抗病毒治疗前样本劣势耐药毒株存在情况。结果抗病毒治疗后患者的HIV-1病毒载量显著下降(t=275,p=0.0001),但CD4+T淋巴细胞绝对数无明显变化(t=1.765168,p=0.0852)。抗病毒治疗失败患者中耐药的发生率为4.88%,ASPCR检测发现,在调查基线时,7例耐药患者全部存在劣势M184V突变、5例存在劣势K103N突变。结论河南省部分未治疗的艾滋病患者存在HIV-1原发性耐药毒株,劣势耐药突变可能发展为优势耐药毒株并影响抗病毒治疗的效果。更多还原

【Abstract】 Objective To evaluate the antiretroviral therapy(ART) and analyze the prevalence of resistance in rural areas,Henan,and explore the presence of minor resistant variants in pre-ART.Methods 149 AIDS patients initiating ART were recruited and investigated at intervals of 6 months.Method of Inhouse developed by our laboratory for genotypic resistance test was to analyze the occurrence of resistance among the failure of ART,and the Allele-specific real-timePCR(ASPCR) was used to detect the minor resistant variants at the baseline samples once the resistance occurred.Results Viral load(VL) significantly decreased among the patients who received ART(t=275,p=0.0001),but the absolute counts of CD4+T lymphocytes had no significant change(t=1.765168,p=0.0852).Rate of resistance among the patients of treatment failure was 4.88%.The result of ASPCR in the survey of baseline showed that the minor resistant variants of M184V were detected in 7 patients and mutation K103N presented in 5 patients.Conclusion The primary drug-resistant strains in the untreated patients were found in Henan,and they might develop the dominant resistance strains and bring about the failure of ART.更多还原