广西贵港市商业异性性传播人群HIV-1基因型耐药分析  

Analysis of genotype drug resistance of HIV-1 in commercial heterosexually transmitted population in Guigang city, Guangxi

作　　者：覃春伟[1] 覃雄林[1] 梁贤君 朱刚劲 徐志良[1] 黄运轩[1] 徐月香[1] 蒋俊俊 陈荣凤 QIN Chun-wei;QIN Xiong-lin;LIANG Xian-jun;ZHU Gang-jing;XU Zhi-liang;HUANG Yun-xuan;XU Yue-xiang;JIANG Jun-jun;CHEN Rong-feng(Guigang Center for Disease Control and Prevention,Guigang,Guangxi 537100,China)

机构地区：[1]贵港市疾病预防控制中心,广西537000 [2]广西医科大学生命科学研究院广西艾滋病防治研究重点实验室

出　　处：《应用预防医学》2020年第5期374-378,共5页Applied Preventive Medicine

基　　金：广西卫生健康委员会自筹项目(Z20180857);广西重点研发计划(桂科AB18050022)。

摘　　要：目的分析贵港市经商业异性性传播途径感染HIV-1患者的耐药情况及其影响因素,为艾滋病防控提供科学依据。方法于2018年6—12月,采用方便抽样方法收集319例经商业异性性行为感染的HIV患者资料并采集血液,提取血浆HIV-1 RNA,PCR扩增pol区序列并测序,应用美国斯坦福大学的HIV耐药数据库进行基因型耐药分析。采用多因素logistic回归模型分析耐药发生的影响因素。结果总耐药率为9.09%(29/319),传播性耐药率为5.00%(5/100),获得性耐药率为10.96%(24/219)。29例耐药病例中以高度耐药水平为主(48.28%)。全部观察病例中蛋白酶抑制剂(PIs)、核苷类逆转录酶抑制剂(NRTIs)、非核苷类逆转录酶抑制剂(NNRTIs)、NRTIs+NNRTIs耐药率分别为0.31%、1.25%、4.39%和3.31%;主要突变位点有M184I/V、M230I和T50L。多因素logistic回归模型分析显示,年龄>60岁是耐药发生的保护因素(OR=0.11,95%CI:0.02-0.62,P=0.01)。结论广西贵港市商业异性性传播HIV感染者耐药率总体处于中等水平,耐药发生受年龄因素的影响。应加强年龄较轻者依从性教育及监测耐药的发生,提高抗病毒治疗效果及预防耐药毒株的发生和传播。Objective To analyze the genotype drug resistance of HIV-1 and its influencing factors through the commercial heterosexual route in Guigang city,and provide scientific basis for AIDS prevention and control.Methods From June to December 2018,a total of 319 HIV infected patients who were infected by commercial heterosexual behavior were collected by the convenience sampling,and their blood samples were collected.HIV-1 RNA from plasma was extracted,and pol genes were amplified and sequenced.The sequences were analyzed for genotype drug resistance by using the Stanford University HIVdb Program library.The factors associated with the drug resistance were analyzed with multivariate logistic regression model.Results The overall drug resistance rate was 9.09%(29/219),the primary drug resistance rate was 5.00%(5/100),and the acquired drug resistance rate was 10.96%(24/219).Among 29 resistant cases,the majority had the high level of drug resistance(48.28%).The resistance rates of protease inhibitors(PIs),nucleoside reverse transcriptase inhibitors(NRTIs),non—nucleoside reverse transcriptase inhibitors(NNRTIs),and NRTIs+NNRTIs in all observed cases were 0.31%,1.25%,4.39% and 3.31%,respectively.The main mutation sites were M184I/V,M230I,and T50L.Multivariate logistic regression analysis showed that age greater than 60 years old was a protective factor of drug resistance(OR=0.11,95% Cl:0.02-0.62,P=0.01).Conclusions The drug resistance rate of commercial heterosexually transmitted HIV infection in Guigang city of Guangxi is at a moderate level generally.The occurrence of drug resistance is affected by the age factor.Compliance education and monitoring the occurrence of drug resistance should be strengthen for the young people,improve the effect of antiviral treatment and prevent the occurrence and spread of drug-resistant strains.

关 键 词：HIV-1 性传播 基因型耐药 影响因素 

分 类 号：R512.911[医药卫生—内科学]