HIV-1暴露儿抗病毒治疗后干血斑RNA和DNA水平动态分析  

Dynamic analysis of RNA and DNA levels in dry blood spots of infants exposed to HIV-1 after antiviral therapy

作　　者：米云婷 徐晴晴 金聪[1] 姚均[1] 王爱玲[3] Mi Yunting;Xu Qingqing;Jin Cong;Yao Jun;Wang Ailing(National Center for AIDS/STD Control and Prevention,Chinese Center for Disease Control and Prevention,Beijing 102206,China;National Institute for Communicable Disease Control and Prevention,Chinese Center for Disease Control and Prevention,Beijing,102206,China;National Center for Women and Children’s Health,Center for Disease Control and Prevention of China,Beijing 100013,China)

机构地区：[1]中国疾病预防控制中心性病艾滋病预防控制中心,北京102206 [2]中国疾病预防控制中心传染病预防控制所,北京102206 [3]中国疾病预防控制中心妇幼保健中心,北京100013

出　　处：《国际病毒学杂志》2024年第2期140-144,共5页International Journal of Virology

基　　金：国家科技重大专项(2015ZX10001001-002)。

摘　　要：目的分析7例HIV-1暴露儿进行抗病毒治疗后的情况以及其干血斑HIV-1 RNA和DNA水平动态变化,探讨影响其治疗结果的相关因素。方法2016—2019年间随访收集7例HIV-1暴露儿出生时至出生2年内多个时间点干血斑,分别定量检测干血斑HIV-1 RNA和DNA水平,以及进行基因型耐药检测分析。最终以定量检测值Log10绘制每例暴露儿各时间点HIV-1 RNA和DNA动态变化图,分析用药后HIV-1 RNA和DNA变化原因。结果7例入组暴露儿有2例持续病毒学抑制近9个月,2例可能因耐药最终未达到持续病毒学抑制,3例因停药导致HIV-1 RNA反弹。7例暴露儿HIV-1 DNA在较高水平维持稳定。未获得有效病毒学抑制的5例暴露儿HIV-1 RNA和DNA水平变化趋势一致(R2=0.487,P=0.021)。结论基于本研究较高的HIV-1暴露儿治疗失败率,需要加强HIV-1阳性孕产妇的母婴传播阻断及基因型耐药检测,同时对抗病毒治疗后具有较高HIV-1 RNA和DNA动态水平的暴露儿加强服药依从性以及实施更高效抗病毒治疗方案。Objective To analyze the post-antiviral-treatment status of seven children exposed to HIV-1 and the changes of HIV-1 RNA and DNA levels in dry blood spots,so as to investigate relevant factors affecting the treatment outcome.Methods From 2016 to 2019,seven infants exposed to HIV-1 were followed and dry blood spots were collected at various time points from delivery to 2 years after birth.The levels of HIV-1 RNA and DNA in dry blood spots were quantified respectively,and the genotypic drug resistance was analyzed.The Brigg’s logarithm values of final quantification results were calculated to draw diagram of HIV-1 RNA and DNA levels at various time points of each case,to explore the reasons for the changes of HIV-1 RNA and DNA after treatment.Results For the seven exposed infants enrolled in the group,2 cases had sustained virologic suppression(SVS)for nearly 9 months,2 cases failed to reach SVS possibly due to drug resistance,and 3 cases suffered HIV-1 RNA rebounded due to treatment cessation.The HIV-1 DNA in seven exposed infants remained stable at a high level.The 5 infants who had no effective virological inhibition showed the same trend of HIV-1 RNA and DNA levels(r2=0.487,P=0.021).Conclusions High treatment failure rate of infants exposed to HIV-1 in this study indicated the necessity to strengthen prevention mother-to-infant transmission and detection of genotypic drug resistance in HIV-1 positive pregnant women.Meanwhile,enhanced compliance management of medication and antiviral therapy of higher efficiency should be implemented to exposed infants with high dynamic levels of HIV-1 RNA and DNA after antiviral treatment.

关 键 词：HIV-1暴露儿 干血斑HIV-1 DNA 干血斑HIV-1 RNA 耐药 

分 类 号：R512.91[医药卫生—内科学]