云南省HIV-1 B(B′)、C亚型毒株的耐药突变分析  

Analysis of Drug-resistance Mutations of HIV-1 B (B′) and C Subtypes in Yunnan Province

作　　者：舒远路 杨翠先 张米 李健健 刘家法 杨壁珲 邓雪媚 董兴齐 SHU Yuanlu;YANG Cuixian;ZHANG Mi;LI Jianjian;LIU Jiafa;YANG Bihui;DENG Xuemei;DONG Xingqi(Dali University,Dali 671000,China;Yunnan Provincial Infections Disease Hospital/AIDS Care Center,Kunming 650301,China)

机构地区：[1]大理大学,云南大理671000 [2]云南省传染病专科医院/艾滋病关爱中心,云南昆明650301

出　　处：《中国皮肤性病学杂志》2019年第5期547-552,共6页The Chinese Journal of Dermatovenereology

基　　金：云南省科技计划(重点新产品开发)(2016BC005)

摘　　要：目的调查云南省艾滋病病毒1型B(B′)、C亚型毒株在ART失败后的耐药突变特征。方法对云南省15个地州定点医院2016年随访ART失败的HIV/AIDS患者的1 591份血浆样本,采用RT-PCR扩增HIV-1 pol区蛋白酶和反转录酶基因,通过BLAST、jpHMM at GOBICS和MEGA6.06软件确证亚型,进行耐药突变位点的分析。结果共获得B(B′)、C亚型毒株分别为27例和63例,其中B(B′)、C亚型检测出发生耐药突变分别为22例和37例,耐药突变率为81.48%和58.73%。病毒载量在B(B′)、C亚型耐药突变的毒株间差异有统计学意义(P<0.05),未耐药突变的毒株间差异无统计学意义(P>0.05)。在所有检出耐药突变位点中,仅K103和A71突变率在两种亚型间差异有统计学意义(P<0.05)。在所有治疗方案中,仅TDF/3TC/EFV方案在两种亚型间的耐药突变率和病毒载量差异有统计学意义(P<0.05)。结论 B(B′)、C亚型毒株ART失败后的耐药突变特征有差异,应加强两种亚型的耐药监测。Objective To investigate characteristics of resistance mutations in HIV-1 B(B′)and C subtypes after failure of antiretroviral therapy(ART)in Yunnan province.Methods From 2016,plasma samples were collected from 1 591 HIV/AIDS patients,who did not respond to ART,from 15 prefectures of Yunnan.Protease and reverse transcriptase gene in HIV-1 pol region were prepared and amplified using RT-PCR,followed by determination of HIV-1 subtypes and analysis of drug resistance mutations.Results Total of 27 subtype B(B′)and 63 subtype C were identified.The resistance mutation rates of B(B′)and C subtypes were 81.48%(22/27)and 58.73%(37/63),respectively.Although viral load was similar between HIV-1 subtype B(B′)and C in strains without drug resistance mutations,it became significantly different between these two subtypes with drug resistance mutations(P<0.05).Among all drug resistance mutation sites,mutation frequencies of both K103 and A71 were significantly different between HIV-1 subtype B(B′)and C(P<0.05).Both viral load and drug resistance mutation rates were significantly different between HIV-1 subtype B(B′)and C in subjects with TDF/3 TC/EFV therapy(P<0.05).Conclusion After failure of ART,characteristics of drug resistance mutations differ significantly between HIV-1 subtype B(B′)and C.It is necessary to strengthen the monitoring these two subtypes.

关 键 词：艾滋病病毒1型 亚型 耐药突变 

分 类 号：R593.32[医药卫生—内科学]