黑龙江省2004～2007年HIV-1毒株耐药基因型检测结果分析  

Analysis on Detection for Genotypic of Drug Resistance Mutations of HIV-1 Strains in Heilongjiang Province between 2004 and 2007

作　　者：王开利[1] 陈淑红[1] 刘彦成[1] 周广恩[1] 张婕[1] 战勇[1] 

机构地区：[1]黑龙江省疾病预防控制中心,哈尔滨150030

出　　处：《中国公共卫生管理》2009年第1期71-73,共3页Chinese Journal of Public Health Management

摘　　要：目的了解黑龙江省部分AIDS患者在接受抗病毒治疗中HIV-1耐药基因的变异情况,为更好地开展抗病毒治疗提供科学依据。方法从患者血浆中抽提病毒RNA,用RT-PCR方法扩增HIV-1 pol区基因片段,进行核苷酸序列测定及耐药基因型分析。结果2005年的2号样本以及2007年的3号和5号样本各存在一处蛋白酶抑制剂次要耐药突变:A71T、L10I、A71T,但它们单独存在不会产生耐药性。2005年的2号样本以及2007年的5号和6号样本均检出逆转录酶抑制剂的耐药突变,其中核苷类逆转录酶抑制剂(NRTIs)耐药突变位点共有5处:D67N、K70R、M184V、K219Q、T215FI,非核苷类逆转录酶抑制剂(NNRTIs)耐药突变位点共有7处:K103T、Y181C、K103N、P225H、K238T、V106A、G190A,最终导致三份样本对NRTIs和NNRTIs类中的多种药物产生不同程度的耐受性。结论被检测的AIDS患者中多数对现有的抗病毒药物敏感,但有3例对多数逆转录酶抑制剂产生耐受性,应该加强HIV感染者/AIDS患者体内HIV-1耐药基因型监测,了解治疗前后总体耐药水平。Objective To understand the drug resistance mutations of reverse transeriptase gene and protease gene of HIV-1 strains in some antiretroviral-treated AIDS patients in Heilongjiang province, and to provide the scientific data for clinical antiviral treatment. Methods HIV-1 RNA were extracted from AIDS patients＇ plasma, and partial pol gene fragments were amplified by using RT-PCR method and were sequenced. Then, the partial pol sequences were analyzed for genotypie drug resistance mutations. Results The analysis indicated that number 2 sample in 2005, number 3 sample in 2007 and number 5 sample in 2007 has one PI minor resistance mutation A71T, L10I and A71T respecdvdy, but the mutations can＇t cause resistance to antiretruviral drugs. Number 2 sample in 2005, number 5 sampla in 2007 and number 6 sample in 2007 have some mutations associated with reverse tmnscriptase （RT） inhibitors. For example, the mutations to NRTIs are D67N, K701q, M184V, K219Q and T215F1, the mutations to NNRTIs are KIO3T, Y181C, K103N, P225H, K238T, V106A and GI90A. These mutations made the three samples have different levels of resistance to most of NRTIs and NNRTIs. Conclusion Among detected samples, the most were sensitive to available antiretroviral drugs, but there were three samples that had resistance to most of the RT inhibitors. That reminded us to pay more attention to the surveillance of HIV-1 drug resistance mutations in our province, and to understand the drug resistance levels among treatment-naive and antiretruviral-treated HIV/AIDS patients.

关 键 词：HIV-1 耐药变异 基因检测 

分 类 号：R512.91[医药卫生—内科学] R446.11[医药卫生—临床医学]