上海地区HIV-1感染者耐药基因型检测及亚型分析  

Analysis of genotypes and subtypes of drug-resistance genes in patients with HIV-1 infection in Shanghai

作　　者：蔡枫[1] 魏飞力[2] 孙洪清[3] 谈亦[3] 高磊[2] 黄琴[3] 曹韵贞[2] 

机构地区：[1]上海市中医医院检验科,上海200071 [2]中国医学科学院艾滋病研究中心,北京100730 [3]上海市公共卫生临床中心感染科,上海201508

出　　处：《检验医学》2009年第11期788-791,共4页Laboratory Medicine

摘　　要：目的研究上海地区人类免疫缺陷病毒(H IV)感染者/获得性免疫缺陷综合征(AIDS)患者耐药性基因型以及亚型的分布情况。方法采用美国拜耳公司H IV耐药检测试剂盒(TRUGENE(H IV-1 Genotyp ingK it),扩增H IV-1靶序列(pol基因)中长度分别为297bp的蛋白酶基因片段和621bp的逆转录酶基因片段,OpenGene(DNA测序系统和数据分析软件进行测序和序列分析,利用H IV Database网站提供的H IV基因亚型分析软件(BLAST)对所得到的靶序列进行亚型分析。结果对87例H IV/AIDS患者的病毒载量和CD4+T淋巴细胞计数4年随访中,其中61例接受高效抗逆转录病毒联合治疗(HARRT)的患者中,有4例性传播患者检测结果显示出现逆转录酶类耐药相关位点,49例合并血友病的患者,服药的依从性好,病毒载量检测均低于检测限(?50拷贝/mL)。10例未接受过HARRT治疗的患者标本中未检出耐药相关突变。对16份标本进行亚型分析,发现1例国内尚未见报道的ADHK重组型。结论利用TRUGENE(H IV-1系统,进行H IV-1耐药性基因型的检测,可以有效地监测接受HARRT治疗前后患者血浆H IV-1的耐药情况,并对不同的亚型进行分析。Objective To study genotypes and subtypes of drug-resistance genes in patients with human immunode- ficiency virus （HIV）/acquired immune deficiency syndrome （AIDS） in Shanghai. Methods A 297 bp protease gene and a 621 bp reverse transcriptase（RT） gene in HIV-1 target genes （pol） were amplified and sequenced by TRU- GENE HIV-1 Genotyping Kit and OpenGene DNA sequencing system. HIV subtypes in the sequences were analysed by means of BLAST supplied by HIV Database network. Results The viral load and CD4 ＋ T cell count were investigated in 87 cases with HIV/AIDS who had been followed up for four years. Drug resistant mutations of RT gene were found in 4 out of 61 cases treated with highly active antiretroviral therapy （HARRT）. There was no mutation detected in 49 cases with HIV/Haemophilia and 10 cases without HARRT treatment. By analysis of HIV-1 subtypes in 16 cases, one case with ADHK recombinant HIV-1 was reported firstly in China. Conclusions HIV-1 genotypic drug-resistant testing and subtypes analysis could be used effectively to monitor drug resistance in the plasma of HIV-1 patients before and after HARRT treatment.

关 键 词：人类免疫缺陷病毒 耐药性 基因型 亚型 

分 类 号：R373[医药卫生—病原生物学]