新疆伊犁州抗病毒治疗者HIV亚型分布和耐药发生情况分析  

A survey of the distribution of HIV subtypes and drug resistance in HIV-infected patients receiving antiretroviral treatment in Yiii prefecture of Xinjiang, China

作　　者：佐合拉·吐尔地[1] 娜尔克孜·阿布扎力汗[1] 王莉 郑薇薇 阮玉华[4] 关晓霞 冷雪冰[4] 董永慧[1] 邢辉[4] 

机构地区：[1]新疆维吾尔自治区疾病预防控制中心性病艾滋病预防控制中心,830002 [2]伊犁州疾病预防控制中心 [3]伊宁市人民医院抗病毒治疗中心 [4]中国疾病预防控制中心性病艾滋病预防控制中心,北京102206

出　　处：《中华微生物学和免疫学杂志》2015年第12期905-909,共5页Chinese Journal of Microbiology and Immunology

摘　　要：目的了解新疆伊犁州接受抗病毒治疗的艾滋病患者HIV亚型和耐药性发生情况。方法2013年对伊犁州接受HIV抗病毒治疗的600名患者进行了调查，采集血液样本进行CD4细胞、病毒载量检测，对病毒载量大于1000拷贝／ml的样本进行HIV-1基因型耐药性检测，应用美国斯坦福大学HIV耐药数据库在线分析病毒亚型和耐药突变情况，对耐药发生的影响因素进行了Logistic回归分析。结果在接受调查的600名患者中，病毒载量大于1000拷贝／ml人数为149人，得到pol区序列146条，耐药人数为57人，总耐药率为9．50％；流行株99．5％为CRF07_BC亚型，仅发现1例B亚型毒株。耐药发生的相关危险因素为最近一个月漏服药物和更换二线药物。结论伊犁州抗病毒治疗人群总耐药率尚高，需要加强服药依从性教育，加强耐药性监测，提高抗病毒治疗的质量。Objective To investigate the distribution of HIV-1 subtypes and the prevalence of drug resistance in AIDS patients receiving antiretroviral treatment in Xinjiang, China. Methods Six hundred patients who were aged ≥ 18 years and received antiretroviral treatment were recruited in this study in 2013 by using cluster sampling. Blood samples were collected from the patients. The numbers of CD4^＋T lymphocytes in peripheral blood samples were measured by using fluorescence activated cell sorting. HIV-1 RNA 3.0 assay was used to detect the viral loads. Nested RT-PCR was performed to amplify the fragments of HIV-1 pol gene extracted from patients whose viral loads ≥1000 copies/ml. The resistant mutations were determined by comparing the sequences with those recorded in Stanford HIV Drug Resistance Database. The factors associated with HIV drug resistance （HIVDR） were identified by using logistic regression analysis. Results Among the 600 patients, 149 patients were screened out with a viral load ≥ 1000 copies/ml. One hundred and forty-six sequences ofpol gene were successfully amplified. Drug resistance was detected in 57 patients out of the 600 HIV-infected patients receiving antiretroviral treatment with an overall drug resistance rate of 9.50%. The predominant subtype of HIV-1 in Yili prefecture was CRF07_BC subtype （99.5% , 189/190）. Only one B subtype strain of HIV-1 was detected. The factors associated with HIVDR included missed doses in the last month and switching to second-line regiments. Conclusion The incidence of HIVDR among HIV-infected patients receiving antiretroviral treatment was relatively high. It is necessary to improve the therapeutic effects of antiretroviral treatment by enhancing the education on medication compliance for patients and strengthening the surveillance of drug resistance.

关 键 词：人类免疫缺陷病毒 高效抗逆转录病毒治疗 耐药 

分 类 号：R512.91[医药卫生—内科学]