新疆阿克苏地区HIV-1抗病毒治疗失败患者基因型耐药特征分析  

Analysis of genotypic drug resistance characteristics of HIV-1 patients with failure of antiretroviral therapy in Aksu prefecture in Xinjiang,China

作　　者：冯疆涛 李虎 董伟 许铭玉 王凤英[2] 金涛[2] 努热艳·阿合尼亚孜 麦尔哈巴·木塔力甫 FENG Jiang-tao;LI Hu;DONG Wei;XU Ming-yu;WANG Feng-ying;JIN Tao;Nureyan AHENIYAZI;Marerhaba MUTALIFU(Center for Disease Control and Prevention of Aksu prefecture,Aksu,Xinjiang 843000,China;不详)

机构地区：[1]阿克苏地区疾病预防控制中心,新疆阿克苏843000 [2]新疆维吾尔自治区疾病预防控制中心

出　　处：《中国国境卫生检疫杂志》2022年第5期403-406,共4页Chinese Journal of Frontier Health and Quarantine

摘　　要：目的分析新疆阿克苏地区HIV-1抗病毒治疗失败患者基因型耐药特征。方法选取新疆阿克苏地区2020年5月—2021年3月期间病毒载量>1000拷贝/ml的HIV感染者664例的血样本,通过套式PCR扩增pol基因,对HIV-1抗病毒治疗失败患者进行耐药检测,将获得的pol基因序列与美国斯坦福大学网络HIV耐药数据库比对,分析耐药因素,确定耐药突变位点及耐药程度。结果664例抗病毒治疗失败患者的耐药率为55.9%,对蛋白酶抑制剂(PIs)、核苷类逆转录酶抑制剂(NRTIs)及非核苷类逆转录酶抑制剂(NNRTIs)的耐药率分别为7.1%、18.2%和50.9%。在PIs、NRTIs和NNRTIs中最常见的突变位点及突变频率依次分别为Q58(83.0%)、M184(87.6%)、K103(71.3%)。结论新疆阿克苏地区需加强服药督导、开展服药依从性教育和宣传引导,同时加强对抗病毒治疗失败患者耐药监测并及时调整抗病毒治疗方案。Objective To analyze the genotypic drug resistance characteristics of HIV-1 patients who failed antiretroviral therapy in Aksu prefecture,Xinjiang.Methods A total of 664 blood samples of HIV-infected samples with viral load>1000 copies/ml were selected from May 2020 to March 2021,Aksu prefecture in Xinjiang,and HIV-1 polymerase pol gene region was amplified by nested PCR.The patients who failed HIV-1 antiviral therapy were tested for drug resistance,and the obtained pol gene sequences were compared in the Stanford University network HIV drug resistance database to analyze the drug resistance factors,and to determine the drug resistant mutation sites.Results The drug resistance rate was 55.9%in 664 patients who failed antiviral therapy.The resistance rates protease inhibitors(PIs),nucleotide reverse transcriptase inhibitors(NRTIs),non-nucleotide reverse transcriptase inhibitors(NNRTIs)were 7.1%,18.2%and 50.9%,respectively.The most common mutation sites and mutation frequencies in PIs,NRTIs and NNRTIs were Q58(83.0%),M148(87.6%),and K103(71.3%),respectively.Conclusion It is necessary to strengthen medication supervision,carrying out medication compliance education,publicity and guidance in Aksu prefecture,Xinjiang.At the same time,to strengthen the surveillance of drug resistance in patients with failed antiviral therapy,adjust the antiviral treatment plan in time.

关 键 词：基因型耐药 抗病毒治疗 艾滋病 耐药 

分 类 号：R512.91[医药卫生—内科学]