吉林市HIV-1感染者基因型耐药分析及亚型分布  

Genotypic drug resistance and subtype distribution in patients infected with HIV-1 in Jilin City,Jilin Province,China

作　　者：周凤岩[1] 李扬[2] 左中宝 邢辉[2] 乔建国[1] 

机构地区：[1]吉林市疾病预防控制中心,吉林吉林132001 [2]中国疾病预防控制中心,北京102206

出　　处：《中国生物制品学杂志》2016年第7期733-736,共4页Chinese Journal of Biologicals

基　　金：吉林市科学技术局立项科学技术进步奖(201437104)

摘　　要：目的观察2014~2015年吉林市内抗病毒治疗失败HIV-1感染者中HIV基因型耐药情况及其亚型分布。方法收集吉林市2014~2015年HIV-1感染者中接受抗病毒治疗后HIV病毒载量≥1 000拷贝/ml的患者血浆样本,提取病毒RNA,进行POL基因区扩增及测序后,使用美国斯坦福大学HIV耐药数据库进行耐药位点分析,Mega 6.0软件Neighbor-joining tree方法构建系统进化树,进行亚型分布分析。结果 2014~2015年275份抗病毒治疗失败人群血浆样本全部扩增成功,共发现106份基因型耐药样本,耐药率为38.5%,其中7份对蛋白酶类药物耐药,82份对核苷类药物耐药,99份对非核苷类药物耐药,有80份同时对核苷类和非核苷类药物耐药。核苷类逆转录酶区耐药位点以M184V/IV突变为主,非核苷类逆转录酶区耐药位点以G190G/A/S和V179D/E/G突变为主,2例蛋白酶类药物主要耐药突变位点分别为A71V/T和L10I/M/V。序列亚型以CRF01_AE为主（64.7%）,主要流行簇以CRF01_AE第4、第5及CRF07_BC第1簇为主。结论耐药位点的出现是影响吉林市HIV感染者抗病毒治疗效果的一个重要原因,应加强对治疗失败患者的耐药监测,及时发现耐药突变,尽早更换药物。Objective To observe the prevalence and characteristics of the HIV genotypic drug resistance and subtypes in HIV-1 infected patients failing in antiviral therapy.Methods Plasma samples with virus loads of not less than1 000 copies/ml were collected from HIV-1-infected patients after antiviral therapy in Jilin City in 2014 ~ 2015,from which viral RNA was extracted for amplification and sequencing of POL genetic region.The resistant mutations were determined by Stanford HIV Drug Resistance Database,while the subtypes of HIV-1 by Mega 6.0 of Neighbor-joining tree.Results Genotypic drug resistances were observed in 106 of the 275 plasma samples,indicating a drug-resistant rate of 38.5%,of which 7 were resistant to proteases,82 to nucleosides,99 to non-nucleosides,and 80 to both nucleosides and non-nucleosides.The resistant mutations in nucleoside reverse transcriptase region were mainly M184 V/V,while those in non-nucleoside reverse transcriptase region were mainly G190 G/A/S and V179 D/E/G.The two major drugresistant mutants to proteases were A71 V/T and L10 I/M/V respectively.The main subtype was CRF01_AE（64.7%）,while the main epidemic clusters of CRF01_AE clusters 4 and 5 as well as CRF07_BC cluster 1.Conclusion Drugresistant mutation was a main cause for failure of antiviral therapy of HIV infection in Jilin City.The monitoring on drug-resistance in patients failing in antiviral therapy should be strengthened so as to find drug-resistant mutation in time and change the drug as early as possible.

关 键 词：HIV-1 抗病毒治疗 基因型 耐药 亚型分析 

分 类 号：R512.91[医药卫生—内科学] R969.4[医药卫生—临床医学]