2010-2015年宜宾市HIV感染者抗病毒治疗耐药情况与分析  

Drug Resistance in HIV-Infected Persons Receiving HIV Antiviral Therapy From 2010 to 2015

作　　者：黄晓玲[1,2] 曾宏[2] 王晓燕[2] 袁丹[3] 王川勇 苏玲[3] 魏东兵[3] 叶黎[3] 许欣[1] HUANG Xiaoling;ZENG Hong;WANG Xiaoyan;YUAN Dan;WANG Chuanyong;SU Ling;WEI Dongbing;YE Li;XU Xin(West China School of Public Health, Sichuan University, Chengdu 610041, Sichuan Province, China;Yibin Center for Disease Control and Prenvention, Yibin 644000, Sichuan Province, China;Sichuan Center for Disease Control and Prevention, Chengdu 610041, Sichuan Province, China.)

机构地区：[1]四川大学华西公共卫生学院,成都610041 [2]宜宾市疾病预防控制中心,四川宜宾644000 [3]四川省疾病预防控制中心,成都610041

出　　处：《寄生虫病与感染性疾病》2018年第2期69-75,共7页Parasitoses and Infectious Diseases

摘　　要：目的了解宜宾市HIV感染者(包括HIV感染者和AIDS)接受抗病毒治疗后的耐药发生状况、HIV-1毒株耐药基因型以及区县分布;为宜宾市建立有效的艾滋病防控措施和制订合理的抗病毒治疗方案提供科学依据,同时指导临床对感染者尤其对耐药患者的用药。方法对2010-2015年宜宾市接受HAART治疗超过6个月的HIV感染者,先进行病毒载量(VL)检测,对VL≥1 000 cps/ml的样本进行PCR扩增、电泳、纯化、基因测序,再对获得序列编辑、拼接、校正、建构基因进化树确定基因型、在线分析耐药突变种类以及突变位点。结果 2010-2015年宜宾市接受VL检测的HIV感染者有1 693例,其中有465例VL≥1 000 cps/ml,249例PCR扩增阳性,120例发生耐药,耐药率为7.09%。耐药患者以对核苷类反转录酶抑制剂(NRTIs)和非核苷类反转录酶抑制剂(NNRTIs)耐药为主,对NRTIs耐药的患者几乎同时对NNRTIs耐药,交叉耐药情况严重;耐药患者以翠屏区最多。结论宜宾市HIV耐药疫情呈现中度流行。2010-2015年宜宾市HIV耐药人数呈现逐年增加趋势。耐药患者以耐NRTIs和NNRTIs为主,交叉耐药比较严重,且对NNRTIs的耐药情况更严重。宜宾市各区县耐药患者分布不均,以翠屏区最多。Objective To investigate the drug resistance strains in HIV patients （including HIV infected person situation and drug - resistant genotypes of HIV - 1 and patients with AIDS ） in Yibin following antiviral treatment and distribution in districts and counties so as to provide a scientific basis for establishing effective AIDS prevention and control measures and making up a rational antiviral treatment plan and guide clinical drug administration in infected persons particularly patients who have developed drug resistance. Methods In 2010 to 2015, in HIV - infected persons having received HAART therapy for more than 6 months in Yibin, initial viral loads （VL） were measured. For samples with VL I〉 1 000 cps/ml, PCR amplification, electrophoresis, purification and gene sequencing were conducted. The obtained sequences were edited, spliced and corrected. A phylogenetic tree was constructed to identify genotypes, and drug resistance mutation types and mutation sites were analyzed on line. Results From 2010 to 2015, viral load detection was conducted in 1 693 HIV infected persons; the viral loads in 465 infected persons was ≥ 1 000 cps/ml. Drug resistance monitoring was conducted in these 465 infected persons and positive PCR amplification was obtained in 249. Drug resistance was developed in 120 （7.09%）. Patients were mainly resistant to nueleoside analog reverse transcriptase inhibitors （NRTIs） and non - nucleoside analog reverse transeriptase inhibitors （NNRTIs） ; cross resistance was serious ; the number of drug -resistant patients was the largest in Cuiping District. Conclusion HIV drug resistance epidemic situation is in a moderately state in Yibin. From 2010 to 2015, the HIV drug resistance population in Yibin was increasing year by year. HIV infected persons in Yibin are mainly resistant to NRTIs and NNRTIs, the cross resistance condition is serious and the resistance to NNRTIs is more serious. The distribution of drug resistance patients in different districts and counties resistant pati

关 键 词：HIV 耐药 HAART 

分 类 号：R512.9[医药卫生—内科学]