2018—2022年达州市抗病毒治疗失败HIV/AIDS患者HIV-1毒株耐药情况分析  

Analysis of drug resistance for HIV-1 patients with treatment failure in Dazhou City from 2018 to 2022

作　　者：林忠荔 王顺东[1] 王芸 张静 袁丹[2] LIN Zhongli;WANG Shundong;WANG Yun;ZHANG Jing;YUAN Dan(Dazhou Center for Disease Control and Prevention,Dazhou 635000,Sichuan Province,China;Sichuan Center for Disease Control and Prevention,Chengdu 610041,Sichuan Province,China)

机构地区：[1]达州市疾病预防控制中心,四川达州635000 [2]四川省疾病预防控制中心,成都610000

出　　处：《预防医学情报杂志》2025年第4期475-480,共6页Journal of Preventive Medicine Information

摘　　要：目的分析2018—2022年达州市HIV/AIDS患者抗病毒治疗情况和基因亚型分布及药耐特征,为评价治疗效果优化治疗方案提供依据。方法采集2018—2022年达州市接受抗病毒治疗6个月以上的HIV/AIDS患者血浆标本进行HIV-1病毒载量检测,对病毒载量≥1000cps/ml的标本进行基因型耐药检测,利用SPSS 26.0软件对不同地区耐药情况和不同基因亚型的耐药突变进行分析,率的比较采用χ^(2)或趋势χ^(2)检验,以P<0.05为差异有统计学意义。结果2018—2022年达州市HIV病毒载量检测覆盖率分别为86.9%、94.7%、94.8%、95.8%和96.8%,差异有统计学意义(χ^(2)=411.683,P<0.001),病毒抑制失败率为9.9%(262/2718)、12.6%(433/3401)、8.0%(354/4240)、7.6%(393/4240)和7.5%(413/4909)。治疗失败耐药率分别为46.8%、47.2%、49.2%、45.9%和45.8%。成功获得692例耐药基因序列,检测出多种基因亚型,CRF01_AE亚型占比最高,为65.8%(455/692),其次是CRF07_BC亚型占22.7%(157/692)。抗病毒治疗药物中非核苷类反转录酶抑制剂(NNRTIs)耐药率明显高于其它药物,其次是核苷类反转录酶抑制剂(NRTIs),蛋白酶抑制剂(PIs)耐药率较低。结论HIV/AIDS患者抗病毒治疗失败率较高,NNRTIs和NRTIs药物耐药问题严重,建议开展治疗前耐药监测以选择最佳治疗方案,提高患者生存质量。Objective To analyze the characteristics of antiretroviral treatment,distribution of gene subtypes and drug resistance characteristics of patients with HIV/AIDS who received antiviral therapy(ATR)in Dazhou city from 2018 to 2022,to provide a basis for evaluating treatment effectiveness and optimizing treatment plans.Methods Plasma samples of HIV/AIDS patients who received antiviral treatment for more than 6 months in Dazhou city from 2018 to 2022 were collected for HIV-1virus load testing.Genotypic drug resistance testing was performed on samples with a virus load of≥1000 cps/ml.SPSS 26.0 software was used to analyze drug resistance in different regions and drug resistance mutations in different gene subtypes.The comparison of rates was conducted by using chi square 2 or trend chi square 2 tests,and the difference P<0.05 was considered statistically significant.Results The coverage rate of HIV viral load detection from 2018 to 2022 was 86.9%,94.7%,94.8%,95.8%and 96.8%,respectively.The difference was statistically significant(χ^(2)=411.683,P<0.001).The viral suppression failure rates were 9.9%(262/2718),12.6%(433/3401),8.0%(354/4240),7.6%(393/4240),and 7.5%(413/4909).The drug resistance rates for treatment failure are 46.8%、47.2%、49.2%、45.9%and 45.8%.Various gene subtypes were detected,CRF01_AE subtype accounted for 65.8%(455/692),followed by CRF07_BC subtype accounting for 22.7%(157/692).The drug resistance of non-nucleoside reverse transcriptase inhibitors(NNRTIs)was significantly higher than that of other drugs,followed by nucleoside reverse transcriptase inhibitors(NRTIs),and protease inhibitors(PIs)rarely showed resistance.Conclusions The causes of antiviral therapy failure in HIV/AIDS patients are complicated,and the problem of NNRTI and NRTI drug resistance is serious.It is recommended to carry out drug resistance monitoring before treatment to select the best treatment plan and improve the quality of life of patients.

关 键 词：HIV 抗病毒治疗 耐药 亚型 

分 类 号：R512.91[医药卫生—内科学]