CAJ | 학술논문

目的了解2008年北京市未经抗病毒治疗HIV-1感染者中耐药株传播水平,为耐药监测和临床抗病毒治疗工作提供本底资料.方法参照WHO提出的HIV耐药警戒线调查方法(HIV drug resistance threshold survey,HIVDR-TS)指导方案,收集6个月内检测发现的60～70名小于25岁的感染者血浆样本,检测HIV-1 pol区亚型及耐药基因型,并计算耐药株检出率、评价传播水平.结果 61份符合要求的样本共获得50个有效pol区序列.感染途径以同性传播为主,占62%;亚型分布以B(42%)、CRF01_AE(28%)、CRF07_BC(26%)3种为主.出现1例针对PI类药物的耐药突变株,检出率为2%(1/50);出现1例针对NRTI类药物的耐药突变株,检出率为2%(1/50);未出现针对NNRTI类药物的耐药突变株,检出率为0.蛋白酶(PR)区和逆转录酶(RT)区的耐药突变株检出率均为2%,均属于低度传播范围(<5%).结论北京市未经抗病毒治疗HIV-1感染者中出现PR和RT区的耐药突变株,传播水平尚处于低流行状态,现有的抗病毒治疗方案是可行的,治疗前尚不需要进行大规模耐药性检测.
목적 료해2008년북경시미경항병독치료HIV-1감염자중내약주전파수평,위내약감측화림상항병독치료공작제공본저자료.방법 삼조WHO제출적HIV내약경계선조사방법(HIV drug resistance threshold survey,HIVDR-TS)지도방안,수집6개월내검측발현적60～70명소우25세적감염자혈장양본,검측HIV-1 pol구아형급내약기인형,병계산내약주검출솔、평개전파수평.결과 61빈부합요구적양본공획득50개유효pol구서렬.감염도경이동성전파위주,점62%;아형분포이B(42%)、CRF01_AE(28%)、CRF07_BC(26%)3충위주.출현1례침대PI류약물적내약돌변주,검출솔위2%(1/50);출현1례침대NRTI류약물적내약돌변주,검출솔위2%(1/50);미출현침대NNRTI류약물적내약돌변주,검출솔위0.단백매(PR)구화역전록매(RT)구적내약돌변주검출솔균위2%,균속우저도전파범위(<5%).결론 북경시미경항병독치료HIV-1감염자중출현PR화RT구적내약돌변주,전파수평상처우저류행상태,현유적항병독치료방안시가행적,치료전상불수요진행대규모내약성검측.
Objective To study the prevalence of HIV-1 drug-resistant strains in antiretroviral therapy-naive HIV-1 infectors,and provide background information for HIV-1 drug resistance survey and clin-ical antiretroviral therapy in Beijing in 2008. Methods Referring to the guidelines for HIV drug resistance threshold survey(HIVDR-TS) of WHO, collecting 60-70 plasma samples of HIV-1 infectors who were detec-ted in 6 months and not more than 25 years,we detected HIV-1 pol genotype and genetic mutations associated with drug resistance,counted the prevalence of drug-resistant strains, and evaluated the prevalent level. Re-Sults Of 61 plasma samples answering for the standards, 50 were successfully sequenced and genotyped pol sequence. The major infection route was homosex, which accounted for 62%. B, CRF01_AE, and CRF07_ BC were major genetic subtype, which accounted for 42%, 28% and 26%, respectively. One Pl-resistant strain was found, the incidence of which was 2% (1/50). One NRTI-resistant strain was found, the inci-dence of which was 2% (1/50). No NRTI-resistant strain was found, the incidence of which was 0. The in-cidence of drug-resistant strains in the protease (PR) region was 2%, and the incidence of reverse tran-scriptase (RT) region was also 2%. Both of the prevalence were classified as low level ( <5% ). Conclu-sion PR, RT-resistant HIV-1 strains were found in drug-naive infectors, and the prevalence was low in Beijing. Current antiretrovirai therapy regiments were still feasible. Most of the AIDS patients did not need to test drug resistance before antiretroviral therapy.