深圳地区未经治疗艾滋病患者蛋白酶和逆转录酶耐药基因变异检测  

Mutations associated with genotypic resistance to antiretroviral therapy in treatment naive acquired immune deficiency syndrome patients in Shenzhen Guangdong China

作　　者：王辉[1] 胡亚冬[2] 李丽雄[1] 徐六妹[1] 朱托夫 周伯平[1] 

机构地区：[1]深圳市东湖医院AIDS研究室,518020 [2]暨南大学艾滋病基因与疫苗开发中心 [3]Department of Laboratory Medicine,School of Medicine,University of Washington,USA

出　　处：《中华传染病杂志》2007年第3期169-174,共6页Chinese Journal of Infectious Diseases

基　　金：深圳市2006年科技计划基金项目(200602020)

摘　　要：目的了解广东省深圳地区部分未经治疗的AIDS患者蛋白酶和逆转录酶耐药基因变异的发生频率和类型。方法收集深圳市45例未经治疗的AIDS患者血浆,用RT-PCR及套式PCR扩增HIV-1 pol区蛋白酶基因全序列与逆转录酶基因部分序列,将反应产物直接进行序列测定,并分析耐药基因的突变情况。结果从45份血浆标本中扩增出41份pol区基因并进行序列测定与分析,蛋白酶基因耐药的主要突变发生率为12.2%(5/41),次要突变发生率为100%(41/41);逆转录酶基因的耐药基因突变发生率为39.0%(16/41)。对上述耐药基因突变的评分表明,对蛋白酶类药物的耐药率为9.8%(4/41);对逆转录酶类药物的耐药率为19.5%(8/41);有1份标本对蛋白酶抑制剂、2份标本对逆转录酶抑制剂潜在耐药。结论深圳地区未经治疗的AIDS患者中存在HIV-1耐药株,但多数患者对现有抗病毒药物敏感。应用抗病毒治疗必须加强监测。保持较好的依从性,防止耐药性毒株的流行。Objective To investigate the presence of human immunodeficiency virus（HIV）-1 strains harboring resistance mutations in naive acquired immune deficiency syndrome（AIDS） patients in Shenzhen of China. Methods Blood samples were collected from 45 individuals. The DNA sequences of protease and partial reverse transcriptase regions （1-238） were determined by reverse transcriptase polymerase chain reaction （RT-PCR） and nest-polymerase chain reaction （PCR） and direct sequencing, their mutations associated with genotypic resistance to antiretroviral therapy in treatment were analyzed. Results Partial pol sequences of 41 samples were successfully amplified. The major mutation rate of resistance to protease inhibitors was 12.2% （5/41） ; the minor mutation rate of resistance was 100.0% （41/41）. The mutation rate of resistance to reverse transcriptase inhibitors was 39.0% （16/41）. According to mutation-scoring system, drug resistance rates to protease inhibitors and reverse transcriptase inhibitors of were 9. 8% （4/41） and 19. 5% （8/41） respectively. One sample was potentially low-level resistant to the protease inhibkors and 2 samples to the reverse transcriptase inhibitors. Conclusions Although drug resistance strains exist in antiretroviral drug naive AIDS patients of Shenzhen, most of them are sensitive to the currently used antiviral medicine. However, the results do remind us to pay more attention to treatment standardization, and to prevent the prevalence of drug resistance stains.

关 键 词：HIV-1 药物耐受性 序列分析 获得性免疫缺陷综合征 突变 

分 类 号：R512.91[医药卫生—内科学]