云南省红河州和德宏州吸毒人群中HIV-1/HCV共感染者HIV-1耐药性分析  

HIV-1 drug resistance among HIV-1/HCV co-infected drug users in Honghe and Dehong Prefectures of Yunnan Province

作　　者：王雨[1,2] 陈鑫 叶梅[3] 熊思东 郑永唐 WANG Yu;CHEN Xin;YE Mei;XIONG Si-dong;ZHENG Yong-tang(College of Pharmaceutical Sciences,Soochow University,215000,China;KIZ-SU Joint Iaboratory of Animal Model and Drug Development,College of Pharmaceutical Sciences,Soochow University,215000,China)

机构地区：[1]苏州大学药学院,215000 [2]苏州大学-中国科学院昆明动物研究所疾病动物模型与新药研发联合实验室,215000 [3]中国科学院昆明动物研究所,650223

出　　处：《传染病信息》2018年第4期356-359,共4页Infectious Disease Information

基　　金：国家自然科学基金面上项目(81271892;81601802);国家自然科学基金委员会-云南联合基金(U1302224)

摘　　要：目的了解云南省红河州和德宏州吸毒人群中HIV-1/HCV共感染者HIV-1耐药情况,为该地区该人群的抗病毒治疗提供理论指导。方法筛查HIV-1/HCV共感染吸毒患者血液样本,对HIV-1 pol基因耐药位点进行测序及比对分析。结果在305例HIV-1/HCV共感染吸毒者中,成功获得pol基因的有202例。其中有32例接受HIV-1抗病毒治疗,81例未接受治疗,89例治疗信息未知。治疗组的耐药发生率为40.6%(13/32),显著高于未治疗组的8.6%(7/81)(P<0.05)。治疗组主要对奈韦拉平、依非韦伦、拉米夫定、司他夫定和恩曲他滨高度耐药,而未治疗组仅个别对沙奎那韦、依曲韦林和利匹韦林高度耐药。结论云南省红河州和德宏州吸毒人群中HIV-1/HCV共感染者HIV-1耐药发生率处于较高水平,且现有的一线、二线治疗方案仍行之有效,一线治疗失败者应尽早转入二线治疗。Objective To investigate the HIV-1 drug resistance among HIV-1/HCV co-infected drug users in Honghe and Dehong Prefectures of Yunnan Province and provide theoretical preference of HIV-1 antiretroviral therapy for HIV-1/HCV co-infected drug users in the areas.Methods Blood samples of HIV-1/HCV co-infected cases were collected through a survey.HIV-1 pol fragment was used for drug resistance mutation sequencing and analysis.Results From 305 HIV-1/HCV coinfected drug users,202 HIV-1 pol fragments were successfully amplified and analyzed.Among them,32 cases received HIV-1 antiretroviral treatment,81 cases did not,the rest 89 cases was unknown.The rate of drug resistance in treated group(40.6%,13/32)was significantly higher than that in untreated group(8.6%,7/81)(P<0.05).Most treated cases exhibited high-level resistance to Nevirapine,Efavirenz,Lamivudine,Stavudine and Emtricitabine;While,only a few untreated cases conferred high resistance to Saquinavir,Etravirine and Rilpivirine.Conclusions The prevalence of HIV-1 drug resistance among HIV-1/HCV co-infected drug users in Honghe and Dehong Prefectures of Yunnan Province is relatively high,and the current first-line and second-line treatments are still effective.Those who failed in first-line treatment are strongly advised to be given second-line treatment as early as possible.

关 键 词：HIV-1/HCV共感染 耐药性 吸毒人群 

分 类 号：R512.91[医药卫生—内科学]