男男同性恋HIV-1感染者原发耐药性分析  

Analysis on primary drug resistance of HIV-1 infected man having sex with man

作　　者：韩晓旭[1] 代娣[1] 卢春明[2] 谷渊[3] 赵彬[1] 张旻[1] 刘静[1] 尚红[1] 

机构地区：[1]中国医科大学附属第一医院卫生部艾滋病免疫学重点实验室,沈阳110001 [2]辽宁省疾病预防控制中心 [3]沈阳市疾病预防控制中心

出　　处：《中国公共卫生》2007年第12期1415-1416,共2页Chinese Journal of Public Health

基　　金：卫生部艾滋病防治应用性研究项目(WA2006-02);第五轮中国全球基金艾滋病项目

摘　　要：目的研究辽宁省男男同性恋者中未经抗病毒治疗的人类免疫缺陷病毒Ⅰ型（HIV-1）感染人群中耐药突变的发生和流行情况。方法收集辽宁省1999～2007年门诊随访的46例HIV-1感染者外周血，提取血浆中HIV基因组RNA，逆转录PCR（RT—PCR）和巢式PCR方法扩增蛋白酶基因全序列和逆转录酶基因1～250氨基酸编码序列，产物纯化后直接进行基因序列测定。序列拼接后，上传至美国斯坦福大学HIV耐药数据库在线进行耐药性分析。结果1例B亚型HIV－1感染者携带针对蛋白酶抑制剂的L90M原发耐药变异，另1例CRF01_AE亚型毒株感染者携带M46I原发耐药变异，而其余病例在蛋白酶编码区只存在次要变异。由高到低依次为．L10I3例，A71T1例。逆转录酶编码区未发现任何耐药变异。结论在辽宁省男男同性恋人群中已经发现有针对蛋白酶抑制剂的耐药毒株的传播。Objective To make sure the HIV-1 drug resistance mutations rate in man who had sex with man in Liaoning province. Methods Totally 46 samples from antiretroviral therapy - naive MSMs were collected. The entire protease gene and 1 N250 amino acids of the reverse transcriptase gene were amplified by RTPCR and nested PCR from genome RNA and sequenced. The results were analyzed with HIVdb - Drug Resistance Algorithm and genotypic resistance mutations were determined to particular anti - HIV drugs. Results One subtype B HIV - 1 infected case carried L90M, a major mutation against protease inhibitors. Another CRF - 01AE HIV - 1 infected case carried M46I, a major mutation against protease inhibitors. Other cases carried only minor mutations： 3 cases carried L10I, 1 case carried A71T. None mutation against reverse transcriptase inhibitors was detected. Conclusion HIV - 1 drug resistance strain transmission was found in MSMs in Liaoning province.

关 键 词：人类免疫缺陷病毒Ⅰ型 原发耐药 男男同性恋 

分 类 号：R512[医药卫生—内科学]