河南省既往献血员感染HIV人群抗病毒治疗后耐药流行及其影响因素的研究  

Study on Prevalence of HIV-1 drug resistance in AIDS former blood donors receiving to HAART in Henan province

作　　者：袁源[1] 刘宏伟[1] 王晓瑜[2] 刘春华[1] 杨丽婷[3] 郑本锋[3] 王霞[3] 阮玉华[3] 邢辉[3] 王哲[1] 邵一鸣 

机构地区：[1]河南省疾病预防控制中心性病艾滋病研究所,河南郑州450016 [2]郑州大学护理学院 [3]中国疾病预防控制中心性艾中心,国家传染病防治重点实验室

出　　处：《现代预防医学》2012年第22期5954-5956,5959,共3页Modern Preventive Medicine

基　　金：河南省重点科技攻关计划项目(102102310003;112102310005);国家十一五重大传染病专项(2008ZX10001-004);河南省卫生科技创新型人才工程专项经费资助

摘　　要：目的对河南省既往献血员抗病毒治疗后HIV-1耐药毒株流行情况及影响因素进行研究。方法对河南部分地区2003～2009年接受抗病毒治疗的既往献血员进行横断面调查访谈和血样采集,实时荧光定量聚合酶链式反应(PCR)方法测定病毒载量和In-House方法进行基因型耐药性分析。结果在616例调查对象中,33.1%(204/616)调查对象检出基因型耐药。多因素Logistic回归分析显示,依从性差(OR=1.83,95%CI1.15～2.93,P=0.0112)、治疗时间(OR=1.73,95%CI1.12～2.66,P=0.0134)和初始治疗方案(OR=2.60,95%CI1.73～3.93,P﹤0.0001)是河南省耐药毒株流行的主要影响因素。结论河南省既往献血员人群中耐药毒株流行率较高并具有随治疗时间升高趋势,建议加强依从性管理,选用适合的初始抗病毒治疗方案,以减少耐药毒株的流行。OBJECTIVE To understand the prevalence of HIV-1 drug resistance in AIDS former blood donors receiving to HAART in Henan province.METHODS Former blood donors treated with HAART from 2003 to 2009 in Henan were investigated by cross-sectional survey and blood samples were collected.HIV-1 viral loads were measured by real-time polymerase chain reaction;genotypic drug resistance was determined by In-house method.RESULTS Prevalence of HIV-1 genotypic drug resistance was 33.1%(204/616).Multivariate Logistic regression analysis showed that the mainly risk factors associated with prevalence of drug resistance included drug nonadherence(OR = 1.83,95%CI 1.15-2.93,P = 0.011 2),duration of treatment(OR = 1.73,95%CI 1.12-2.66,P = 0.013 4,)and initial regimen with ddI(OR = 2.60,95%CI 1.73-3.93,P﹤0.000 1).CONCLUSION The prevalence of HIV-1 drug resistance among ART patients in Henan was high and had tended to increase with treatment time.Measures about adherence and initial regimen should be taken to reduce the prevalence of the drug resistance.

关 键 词：人类免疫缺陷病毒 高效抗逆转录病毒治疗 耐药监测 

分 类 号：R512.91[医药卫生—内科学]