南京地区HIV耐药基因型与艾滋病患者临床治疗效果分析  

Analysis of relationship between drug resistance genotype of HIV and clinical treatment effect for AIDS patients in Nanjing

作　　者：倪俊明 孙梅 吴旭平 NI Junming;SUN Mei;WU Xuping(Precision Medicine Center,Nanjing Hospital Affiliated to Nanjing University of Chinese Medicine,National Key Laboratory of Traditional Chinese Medicine,Nanjing 210003,Jiangsu,China)

机构地区：[1]南京中医药大学附属南京医院精准医学中心,国家中医药重点实验室,南京210003

出　　处：《临床检验杂志》2024年第6期466-468,共3页Chinese Journal of Clinical Laboratory Science

摘　　要：目的分析HIV耐药基因型对艾滋病(AIDS)患者抗病毒治疗效果的影响。方法以499例AIDS患者为研究对象,检测其耐药基因型并与数据库比对,同时检测样本病毒载量与CD4*淋巴细胞绝对计数,对耐药基因型及临床治疗效果进行分析。结果在499例研究病例中,成功扩增测序409例,发生耐药181例。发生耐药患者的年龄显著大于未耐药患者,且CD4+绝对细胞计数显著低于未耐药患者。核苷酸逆转录酶抑制剂(NRTI)和非核苷酸逆转录酶抑制剂(NNRTI)相比蛋白酶抑制剂(PI)更易发生高度耐药。同时,耐药患者具有更高的病毒载量。结论南京地区AIDS患者的总体耐药发生率较低,但耐药患者中多重耐药及高度耐药比例较高。在诊疗过程中,应监测临床指标,及时调整抗病毒治疗方案,优先选择高耐药屏障的抗病毒药物。Objective To analyze the influence of HIV drug resistance genotypes on the outcomes of antiretroviral treatment in AIDS patients.Methods A total of 499 AIDS patients were included as the research subjects.Drug resistance genotypes were detected and compared with the database.Simultaneously,viral load and the absolute counts of CD4*lymphocyte were measured.The genotypes of drug resistance and effects of clinical treatment were analyzed.Results Among the 499 cases studied,409 samples were successfully amplified and sequenced,and 181 cases occurred drug resistance.The patients with drug resistance were significantly older than those without drug resistance,and their CD4 absolute cell counts were significantly lower.Nucleoside reverse transcriptase inhibitors(NR-TI)and non-nucleoside reverse transcriptase inhibitors(NNRTIs)were more likely to develop high-level drug resistance compared to protease inhibitors(PI).Additionally,drug-resistant patients had higher viral loads.Conclusion The overall incidence of drug resist-ance in AIDS patients in Nanjing area is relatively low,but the proportion of multidrug-resistant and highly resistant patients among those with drug resistance is relatively high.During diagnosis and treatment,clinical indicators should be monitored,and antiretroviral treatment plans should be adjusted in a timely manner with preference given to the antiretroviral drugs with high resistance barriers.

关 键 词：艾滋病 耐药 基因型 病毒载量 抗病毒治疗 

分 类 号：R446[医药卫生—诊断学]