上海市浦东HIV-1感染者抗病毒治疗效果及耐药研究  

Study on treatment effect and drug resistance for HIV-1-infected individuals receiving antiretroviral therapy in Shanghai Pudong

作　　者：马平[1] 赵希畅[1] 孙乔[1] 张枭[1] 王涛[1] 辛辛[1] 张鹏[1] 金樱枝[1] 瞿镇宇 付文婕 陈盼盼[1] 裴启星 

机构地区：[1]上海市浦东新区疾病预防控制中心复旦大学浦东预防医学研究院,上海200136

出　　处：《现代预防医学》2017年第10期1887-1890,1894,共5页Modern Preventive Medicine

基　　金：浦东新区科委项目:浦东新区艾滋病治疗及新发现感染者基因特性分析及耐药性研究(PKJ2013-Y37)

摘　　要：目的了解浦东2014年-2015年进入高效抗逆转录病毒治疗HIV-1感染者随访6~12个月抗病毒治疗效果及继发耐药率。方法建立抗病毒治疗监测队列,检测治疗前及治疗12个月血样中病毒载量并进行CD4计数,评估治疗效果,提取核酸,以巢式RT-PCR方法扩增HIV-1感染者样品HIV-1聚合酶片段,测序,将获得的核酸序列提交至斯坦福大学HIV耐药数据库进行耐药位点分析,观察队列继发耐药率。结果经过12个月抗病毒治疗,84.69%的(83/98)病例CD4 T淋巴细胞上升0~300 cell/μl及以上,病毒载量大于5 000 IU/ml的比例由64.29%(63/98)下降到5.10%(5/98),病毒载量小于50 IU/ml的比例由6.12%(6/98)上升到83.67%(82/98),继发耐药率为2.04%(2/98)。结论治疗队列内病人服药依从性较高,有着良好的抗病毒治疗效果,上海市浦东继发耐药率维持在较低水平,一线治疗药物有效。Objective The aim of this study was to assess the rate of drug resistance and treatrrient effect among HIV-l-infected individuals receiving antiretroviral therapy in Pudong. Methods HIV antiretroviral therapy cohort was recruited. Virus load and CD4 celt counts were performed at time point of before initiating the antiretroviral therapy and 6 and 12 months fol- low-up,to assess treatment effect. HIV-1 pol gene were amplified by nest RT-PCR, and sequenced. Drug resistance associated mutations in protease and reverse transcriptase regions were analyzed with Stanford University HIV/AIDS Drug Resistance Database. Results In the cohort of 98 patients undergoing treatment for 12 months, CD4 cell counts in 84.69% （83/98） of the patients rose from 0 to 300.The proportion of patients with more than 5000IU/ml virus load went down from 64.29% （63/98）to 5.10% （5/98）. The proportion of patients with less than 50IU/ml virus load went up from 6.12% （6/98） to 83.67% （82/98）. The secondary drug resistance rate was found to be 2.04%（2/98）. Conclusion The patients in cohort had good com- pliance.The secondary drug resistance rate was relatively low in Pudong. The drugs used in China were largely effective.

关 键 词：HIV-1 抗逆转录病毒治疗 耐药突变 耐药监测 CD4计数 病毒载量 

分 类 号：R183[医药卫生—流行病学]