甘肃省某机构2015年抗病毒治疗病人HIV耐药结果分析  

Analysis of HIV drug-resistance surveillance among patients receiving antiretroviral therapy in 2015 in a hospital of Gansu province

作　　者：余爱玲[1] 王晓蕊[1] 白莉[1] 许亚宁[1] 左中宝 杨常敏[1] 阮玉华[2] 石林[1] 邢辉[2] 周莹荃 邵一鸣 王建云 孟蕾[1] Yu Ailing Wang Xiaorui Bai Li Xu Yaning Zuo Zhongbao Yang Changmin Ruan Yuhua Shi Lin Xing Hui Zhou Yingquan Shao Yiming Wang Jianyun Meng Lei(Gansu Center for Disease Control and Prevention, Lanzhou, 730000, China National Center for HIV/STD Control and Prevention, Chinese Center for Disease Control and Prevention Lanzhou Infectious Diseases Hospital)

机构地区：[1]甘肃省疾病预防控制中心,兰州730000 [2]中国疾病预防控制中心性病艾滋病预防控制中心,北京102206 [3]兰州市肺科医院,兰州730000

出　　处：《中国艾滋病性病》2016年第11期864-866,共3页Chinese Journal of Aids & STD

摘　　要：目的了解甘肃省当前艾滋病抗病毒治疗人群中艾滋病病毒(HIV)耐药株的流行状况,为甘肃省有效开展艾滋病抗病毒治疗提供依据。方法采用横断面调查方法,对甘肃省某机构初始抗病毒治疗9-15个月的43例成人病人进行访谈和采集血样,检测免疫学指标(CD4+T淋巴细胞)、病毒载量(VL)和耐药性指标(基因型突变)。对病毒载量≥1000拷贝/mL的血样进行耐药基因型检测。结果调查的43例病人,男性93.0%(40例)、汉族93.0%(40例)、大专及以上文化程度39.5%(17例)、城镇户口65.1%(28例)、同性性传播46.5%(20例)。3例病毒抑制失败,其中2例出现耐药,治疗人群中的耐药率为4.7%(2例),所有耐药病人均同时对核苷类及非核苷类反转录酶抑制剂耐药,没有病人对蛋白酶抑制剂耐药。耐药病人服药依从性良好。结论甘肃省抗病毒治疗人群中已经出现耐药现象,治疗失败病人主要是因为发生耐药,应加强开展规范合理的抗病毒治疗,及时进行耐药监测以预防耐药株的传播和流行。Objective To understand the drug-resistance status of human immunodeficiency virus（HIV）among patients receiving antiretroviral therapy in Gansu province,and provide evidence for effectively promoting antiretroviral therapy.Methods A cross-sectional survey was conducted to interview the 43 adult patients who initially received antiretroviral therapy for 9-15 months in a hospital,and their blood samples were collected for CD4^＋T cells test and viral load test.The samples with the viral load equal to or above 1000cp/ml would be further detected for their drug-resistance genes associated with HIV.Results Among the 43 patients,male 93.0%（40）,ethnic Han93.0%（40）,college education level 39.5%（17）,urban household 65.1%（28）and homosexual transmission46.5%（20）took great proportions respectively.Out of the three patients experiencing in virological failure,two were found HIV-resistant,accounting for 4.7%（2）.Both HIV-resistant patients were resistant to nucleotide reverse transcriptase inhibitors（NRTIs）and non-nucleotide reverse transcriptase inhibitors（NNRTIs）simultaneously,and neither of them was resistant to protease inhibitors.The medication compliance of the HIV-resistant patients was good.Conclusion HIV drug-resistance occurred among patients receiving antiretroviral therapy in Gansu,which results primarily in virological failure.It is suggested that standardized antiretroviral treatment should be promoted,and HIV drug-resistance surveillance should be strengthened to prevent the occurrence and spread of drugresistance strains.

关 键 词：艾滋病病毒感染者/艾滋病病人 抗病毒治疗 耐药 

分 类 号：R512.91[医药卫生—内科学]