239例治疗失败的HIV感染者HIV-1亚型及耐药分析  

HIV-1 subtypes and drug resistance among 239 HIV-1 patients with virological failure after antiviral therapy

作　　者：赵砚[1] 吕娅妮[1] 康续 鄂爽[1] 潘珊[1] 王莉[1] 姚文清[1] ZHAO Yan;LYU Yani;KANG Xu;E Shuang;PAN Shan;WANG Li;YAO Wenqing(Liaoning Provincial Center for Disease Control and Prevention,Liaoning 110005,China)

机构地区：[1]辽宁省疾病预防控制中心,沈阳110005

出　　处：《中国艾滋病性病》2020年第10期1045-1048,共4页Chinese Journal of Aids & STD

摘　　要：目的分析辽宁地区抗病毒治疗失败的艾滋病病毒(HIV)感染者HIV-1亚型特征及耐药情况。方法收集2018年接受抗病毒治疗满6个月且HIV-1病毒载量≥1000拷贝/mL的治疗失败病例血浆样本239份,通过核酸提取、pol基因区扩增和测序,进行亚型分析及基因型耐药检测。结果239份样本中,HIV-1亚型中CRF01AE占75.7%,B亚型占10.9%,CRF07BC占7.5%;有148例发现耐药位点突变,总耐药率为61.9%(148例);最常见的突变位点为G190、M184和K65,突变率分别为32.6%(78例)、30.1%(72例)和29.7%(71例);对蛋白酶抑制剂(PIs)、核苷类反转录酶抑制剂(NRTIs)及非核苷类反转录酶抑制剂(NNRTIs)的耐药率分别为5.9%(14例)、49.0%(117例)和59.0%(141例)。结论辽宁地区治疗失败的感染者HIV-1基因亚型以CRF01AE为主,耐药突变率处于中等水平,但已出现蛋白酶抑制剂类药物耐药情况,需加强耐药监测及抗病毒治疗管理,以防止耐药毒株传播。Objective To analyze the characteristics of HIV-1 subtypes and drug resistance among HIV-1 patients with virological failure after antiviral therapy in Liaoning province.Methods 239 plasma samples with HIV/AIDS were collected in 2018.All the samples had received antiviral therapy beyond 6 months and the viral loads≥1000 copies/ml.Virus subtypes analysis and drug resistance detection were proceeded by means of HIV-1 pol gene amplification and sequencing.Results Among 239 cases,the proportion of subtype CRF01_AE was the highest,followed by B and CRF07_BC.The rates of drug resistance gene mutation was 61.9%(148)in the patients with virological failure.The main sites of gene mutation were G190,M184 and K65,and the mutation rates were 32.6%(78),30.1%(72)and 29.7%(71),respectively.The drug resistance rates of protease inhibitors(PIs),nucleoside reverse transcriptase inhibitors(NRTIs)and non-nucleoside reverse transcriptase inhibitiors(NNRTIs)were 5.9%(14),49.0%(117)and 59.0%(141),respectively.Conclusion Among HIV-1 patients with virological failure in Liaoning,CRF01_AE is the main HIV-1 gene subtype,and the drug resistance mutation rate is in a medium level.However,a protease inhibitors drug resistance has been discovered.Drug resistance monitoring and antiviral therapy management should be strengthened to avoid the spread of drug-resistant strains.

关 键 词：艾滋病病毒 基因亚型 耐药 抗病毒治疗 

分 类 号：R512.91[医药卫生—内科学]