2011年广西部分地区HIV耐药株发生情况分析  

HIV-1drug resistant strains in some areas of Guangxi in 2011:a cross-sectional survey

作　　者：李剑军[1] 刘伟[1] 梁富雄[1] 朱金辉[1] 周崇兴[1] 方宁烨[1] 王江伟[1] 王斌[1] 梁淑家[1] 

机构地区：[1]广西壮族自治区疾病预防控制中心,南宁530028

出　　处：《中国艾滋病性病》2015年第2期117-119,131,共4页Chinese Journal of Aids & STD

基　　金：广西壮族自治区卫生厅自筹经费科研课题(Z2010033)~~

摘　　要：目的了解广西部分地区已接受高效抗反转录病毒治疗(HAART)的病人中,艾滋病病毒(HIV)耐药株的发生情况。方法对南宁市和崇左市2011年已接受HAART>6个月的病人,进行横断面调查并采集血液样本检测HIV-1病毒载量,对病毒载量>1000拷贝/mL的样本进行耐药基因型分析。结果两市共调查并成功采集了1472例病人的血液样本,病毒未抑制率为4.6%(68/1472),最终获得64份序列用于耐药分析。发现对非核苷类反转录酶抑制剂(NNRTIs)和核苷类反转录酶抑制剂(NRTIs)最主要耐药突变位点分别为G190A和M184V,未发现蛋白酶类抑制剂(PIs)有耐药突变,3类药物的耐药率分别为1.9%(28/1468)、1.6%(24/1468)和0.0%(0/1468),总耐药率为3.5%(52/1468)。52例病人出现了耐药,其中43.8%(28/64)病毒抑制失败病人对NNRTIs耐药,37.5%(24/64)对NRTIs耐药,29.7%(19/64)对NNRTIs和NRTIs双重耐药,81.3%(52/64)至少对某类药物有耐药。结论两个地区2011年已接受HAART人群中,HIV耐药株发生率较低,但出现了对NNRTIs和NRTIs双重耐药,值得关注。Objective To investigate the occurrance of HIV-1drug resistant strains among the HIV/AIDS patients with highly active antiretroviral therapy（HAART）.Methods A cross-sectional survey was conducted among the HIV/AIDS patients with HAART for more than 6months in Nanning city and Chongzuo city from Guangxi in2011.The blood samples were collected and the HIV-1viral load was tested.Drug-resistance genotypes were detected for the samples with viral loads higher than 1000copies/mL.Results A total of 1 472HIV/AIDS patients were investigated.There were 68 individuals with HIV-1viral loads higher than 1000copies/mL.The rate of the virus no inhibition was 4.6%（68/1472）.Sixty-four gene sequences acquired were used for genotypic resistance analysis.The primary mutations of drug resistance were G190 Aand M184Vfor NNRTIs and NRTIs,respectively.PIs were not found to have HIV-1drug resistance mutations.Drug resistance rates of NNRTIs,NRTIs and PIs were 1.9%（28/1468）,1.6%（24/1468）and 0.0%（0/1468）,respectively,which the overall rate was 3.5%（52/1468）.Fifty-two individuals among 64 individuals with HIV-1viral loads higher than 1000copies/mL indicated drug resistance,in which 43.8%（28/64）exhibited NNRTIs drug resistance,37.5%（24/64）NRTIs drug resistance,and29.7%（19/64）dual NNRTIs and NRTIs drug resistance.Conclusion The rate of HIV-1drug resistant strains among the HIV/AIDS patients with HAART more than 6months in Nanning city and Chongzuo city from Guangxi in2011 was low,but we need to pay more attention to the occurrence of the dual drug resistance for NNRTIs and NRTIs.

关 键 词：艾滋病病毒感染者/艾滋病病人 高效抗反转录病毒治疗 耐药株 

分 类 号：R373.9[医药卫生—病原生物学]