江苏省艾滋病患者HIV-1耐药株的流行及影响因素研究  

Drug resistance of HIV-1 strain and its associated factors in AIDS patients in Jiangsu province

作　　者：肖占沛[1] 郭宏雄[2] 还锡萍[2] 傅更锋[2] 徐晓琴[2] 胡海洋[2] 杨传坤[1] 羊海涛[2] 

机构地区：[1]东南大学公共卫生学院,江苏南京210009 [2]江苏省疾病预防控制中心,江苏南京210009

出　　处：《南京医科大学学报（自然科学版）》2012年第9期1314-1319,共6页Journal of Nanjing Medical University(Natural Sciences)

基　　金：江苏省社会发展计划资助(BE2009685);江苏省自然科学基金(BK2009432;BK2009435);江苏省医学重点人才资助(RC2011083;RC2011086;RC2011087)

摘　　要：目的:了解江苏省艾滋病患者的耐药性,并探讨其影响因素。方法:以正在接受抗病毒治疗的艾滋病患者为研究对象,整群抽取了1 022人,对其进行问卷调查和血液采集,采用基因型耐药分析法对其进行耐药性检测。结果:共877名研究对象被纳入分析,人类免疫缺陷病毒(HIV-1)毒株总耐药率为6.50%。CD4水平低、独居、收入水平低、感染时间长、抗病毒治疗时间长和最近1个月出现HIV相关临床症状等因素是HIV-1耐药毒株产生的危险因素。结论:江苏省抗病毒治疗人群目前耐药率处于较低水平,但耐药个体核苷类逆转录酶抑制剂(NRTI)和非核苷类逆转录酶抑制剂(NNRTI)双重耐药突出;应多关注病程较长、抗病毒治疗时间较长、身体免疫状况较差、收入水平较低、居住状况不稳定的患者,增加CD4检测和耐药检测的频率,以尽早发现耐药情况,降低耐药毒株的发生和传播,提高抗病毒治疗的疗效,进而减少艾滋病患者的死亡。Objective：To investigate the prevalence of human immunodeficiency virus-1（HIV-1） drug resistance and related factors in acquired immunodificiency syndrome（AIDS） patients in Jiangsu province.Methods：One thousand and twenty-two AIDS patients who received antiretroviral therapy were recruited with cluster sample method in this study.All participants were asked to complete a questionnaire.The mutation of HIV drug resistance was determined through sequencing pol gene of HIV-1.Results：A total of 877 subjects were enrolled in the analysis.The total drug resistance rate was 6.50%.The prevalence of HIV drug resistance in AIDS patients with low level of CD4 cells in blood,solitary,low income level,long infection time,long treatment time and having HIV-related clinical symptoms is higher than others.Conclusion：The prevalence of HIV-1 drug resistance in AIDS patients receiving antiretroviral therapy was low in Jiangsu.However,among AIDS patients who are resistant to antiviral drug,most of them are resistant to NRTIs and NNRTIs which are two kinds of drugs in first-line antiviral therapy.More attention should be paid to the patients who were with long infection time,long treatment time,low income level,poor state of the body＇s immune and living in unstable.It is necessary to increase the testing frequency of viral load and drug resistance as early as possible in order to reduce the death of AIDS.

关 键 词：HIV-1 药物耐受性 影响因素 

分 类 号：R181.13[医药卫生—流行病学]