CAJ | 학술논문

目的了解浙江省HIV-1主要流行毒株CRF01_AE在治疗人群和未治疗人群中的基因型耐药变异情况.方法选取2004-2007年间收集的HIV感染者样本,对HIV蛋白酶(PR)全长和部分反转录酶(RT)基因区进行RT-PCR扩增测序.分析56个感染CRF01_AE重组亚型样本的序列,其中未治疗组43例,已治疗组13例.使用Stanford HIV Drug Resistance Database(http://hivdb.stanford.edu)的在线耐药序列分析软件HIV DB进行序列分析,寻找耐药相关突变位点.结果未治疗组CD4+T淋巴细胞中位数为229个/mm3,病毒载量log10.中位数为3.41,存在基因型耐药突变率的发生(5/43,11.6%),检出包括PR区第10、46、71位和RT区的第103、118位氨基酸的耐药相关突变;治疗组CD4+T淋巴细胞中位数为186个/mm3,病毒载量log10中位数为3.91,13例中有8例发生了基因型耐药变异(61.5%).检出29个基因型耐药突变.耐药率较高且多表现为交叉耐药.结论浙江省未治疗的HIV感染者存在一定程度的基因型耐药突变;已开始治疗的HIV感染者基因型耐药突变发生率较高,而且交叉耐药现象广泛存在.
목적 료해절강성HIV-1주요류행독주CRF01_AE재치료인군화미치료인군중적기인형내약변이정황.방법 선취2004-2007년간수집적HIV감염자양본,대HIV단백매(PR)전장화부분반전록매(RT)기인구진행RT-PCR확증측서.분석56개감염CRF01_AE중조아형양본적서렬,기중미치료조43례,이치료조13례.사용Stanford HIV Drug Resistance Database(http://hivdb.stanford.edu)적재선내약서렬분석연건HIV DB진행서렬분석,심조내약상관돌변위점.결과 미치료조CD4+T림파세포중위수위229개/mm3,병독재량log10.중위수위3.41,존재기인형내약돌변솔적발생(5/43,11.6%),검출포괄PR구제10、46、71위화RT구적제103、118위안기산적내약상관돌변;치료조CD4+T림파세포중위수위186개/mm3,병독재량log10중위수위3.91,13례중유8례발생료기인형내약변이(61.5%).검출29개기인형내약돌변.내약솔교고차다표현위교차내약.결론 절강성미치료적HIV감염자존재일정정도적기인형내약돌변;이개시치료적HIV감염자기인형내약돌변발생솔교고,이차교차내약현상엄범존재.
Objective To study the genotypic drug-resistant mutation among treat-naive or treated patients infected with HIV-1 CRF01_AE in Zhejiang province during 2004-2007. Methods HIV-i pol amplicons (PR+RT) from 13 treated and 43 treat-naive patients were obtained by reverse transcription-polymerase chain reaction (RT-PCR). The sequences were analyzed for genotypic antiretroviral resistance through online tools (http://hivdb.stanford.edu). Results The median count of CD44+ T lymphocytes in 43treat-naive patients was 229 cells/mm3 and the median log10 viral load was 3.41. Some drug-resistant mutations were seen in these samples including amino acid 10, 46, 71, in the genes of protease (PR) and 103, 118, in the genes of reverse transcriptase (RT) whereas twenty-nine resistance mutations in the genes of PR and RT were obtained in the 13 treated patients (8/13, 61.5% ). The high prevalence of drug-resistant mutations was observed in patients who had been receiving HAART (hight active antiretroviral therapy). Among them, cross drug resistance was dominant. Correspondingly, the median counts of CD44+ T lymphocytes and the log10 viral load were 186 cells/mm3 and 3.91. Conclusion There was a low prevalence of genotypic drug-resistant mutations in treat-naive patients, but higher drug-resistant mutation in treated patients. More attention should be paid to the transmission of drug-resistant HIV strains and the antiretroviral therapy recipe should be adjusted correspondingly for the development of ART drugs, intervention as well as clinical therapy programs.