中华检验医学杂志
中華檢驗醫學雜誌
중화검험의학잡지
CHINESE JOURNAL OF LABORATORY MEDICINE
2011年
4期
315-320
,共6页
杨绍敏%樊移山%李惠琴%杨壁珲%李健健%高丽%钟敏%雷素云%周曾全
楊紹敏%樊移山%李惠琴%楊壁琿%李健健%高麗%鐘敏%雷素雲%週曾全
양소민%번이산%리혜금%양벽혼%리건건%고려%종민%뢰소운%주증전
抗逆转录病毒治疗,高效%HIV-1%pol基因产物,人免疫缺陷病毒%抗药性,细菌%突变%逆转录聚合酶链反应
抗逆轉錄病毒治療,高效%HIV-1%pol基因產物,人免疫缺陷病毒%抗藥性,細菌%突變%逆轉錄聚閤酶鏈反應
항역전록병독치료,고효%HIV-1%pol기인산물,인면역결함병독%항약성,세균%돌변%역전록취합매련반응
Antiretroviral therapy,highly active%HIV-1%pol gene products,human immunodeficiency virus%Drug resistance,bacterial%Mutation%Reverse transcriptase polymerase chain reaction
目的 调查云南省德宏和昆明两个地区HIV-1流行毒株pol区基因在接受HAART后的变异情况.方法 选择接受HAART 1年以上血浆HIV-1病毒载量＞1 000拷贝/ml的139例HIV/AIDS患者,提取血浆中HIV-1 RNA,采用RT-nested-PCR扩增HIV-1的pol区基因蛋白酶(PR)和逆转录酶(RT)基因片段,测定DNA序列.经拼接整理后与美国斯坦福大学网站提供的HIV耐药数据库(Stanford HIV Drug Resistance Database)进行比对,分析耐药突变位点,采用MEGA 4.1构建系统进化树以确定HIV的亚型,结合HIV/AIDS患者流行病学资料进行综合分析.结果 昆明地区患者HIV以T215F/NY/I、M41L/M和T69G/N/I/S/A/D突变较多,突变率分别为39%(24/62)、27%(17/62)和27%(17/62),高于德宏地区患者HIV的相应突变率[分别为16%(11/69)、13%(9/69)和9%(6/69)],差异有统计学意义(x2值分别为8.646、4.242和7.909,P均＜0.05).德宏地区HIV-1流行毒株pol区基因亚型主要为CRF01_AE亚型为32%(22/69)、C亚型为25%(17/69)、B亚型19%(13/69).而昆明地区主要是08_BC亚型60%(37/62)、CRF01_AE亚型21%(13/62)和07_BC亚型15%(9/62).结论 云南省德宏、昆明两地区HIV-1流行毒株pol区基因PR、RT基因突变频率存在部分差异,昆明地区T215F/N/Y/I、M41L/M和T69G/N/I/S/A/D突变率高于德宏地区.两地共检出HIV-1流行毒株pol区基因CRF01_AE、B、C、BC、08_BC和07_BC共6种基因亚型.
目的 調查雲南省德宏和昆明兩箇地區HIV-1流行毒株pol區基因在接受HAART後的變異情況.方法 選擇接受HAART 1年以上血漿HIV-1病毒載量＞1 000拷貝/ml的139例HIV/AIDS患者,提取血漿中HIV-1 RNA,採用RT-nested-PCR擴增HIV-1的pol區基因蛋白酶(PR)和逆轉錄酶(RT)基因片段,測定DNA序列.經拼接整理後與美國斯坦福大學網站提供的HIV耐藥數據庫(Stanford HIV Drug Resistance Database)進行比對,分析耐藥突變位點,採用MEGA 4.1構建繫統進化樹以確定HIV的亞型,結閤HIV/AIDS患者流行病學資料進行綜閤分析.結果 昆明地區患者HIV以T215F/NY/I、M41L/M和T69G/N/I/S/A/D突變較多,突變率分彆為39%(24/62)、27%(17/62)和27%(17/62),高于德宏地區患者HIV的相應突變率[分彆為16%(11/69)、13%(9/69)和9%(6/69)],差異有統計學意義(x2值分彆為8.646、4.242和7.909,P均＜0.05).德宏地區HIV-1流行毒株pol區基因亞型主要為CRF01_AE亞型為32%(22/69)、C亞型為25%(17/69)、B亞型19%(13/69).而昆明地區主要是08_BC亞型60%(37/62)、CRF01_AE亞型21%(13/62)和07_BC亞型15%(9/62).結論 雲南省德宏、昆明兩地區HIV-1流行毒株pol區基因PR、RT基因突變頻率存在部分差異,昆明地區T215F/N/Y/I、M41L/M和T69G/N/I/S/A/D突變率高于德宏地區.兩地共檢齣HIV-1流行毒株pol區基因CRF01_AE、B、C、BC、08_BC和07_BC共6種基因亞型.
목적 조사운남성덕굉화곤명량개지구HIV-1류행독주pol구기인재접수HAART후적변이정황.방법 선택접수HAART 1년이상혈장HIV-1병독재량＞1 000고패/ml적139례HIV/AIDS환자,제취혈장중HIV-1 RNA,채용RT-nested-PCR확증HIV-1적pol구기인단백매(PR)화역전록매(RT)기인편단,측정DNA서렬.경병접정리후여미국사탄복대학망참제공적HIV내약수거고(Stanford HIV Drug Resistance Database)진행비대,분석내약돌변위점,채용MEGA 4.1구건계통진화수이학정HIV적아형,결합HIV/AIDS환자류행병학자료진행종합분석.결과 곤명지구환자HIV이T215F/NY/I、M41L/M화T69G/N/I/S/A/D돌변교다,돌변솔분별위39%(24/62)、27%(17/62)화27%(17/62),고우덕굉지구환자HIV적상응돌변솔[분별위16%(11/69)、13%(9/69)화9%(6/69)],차이유통계학의의(x2치분별위8.646、4.242화7.909,P균＜0.05).덕굉지구HIV-1류행독주pol구기인아형주요위CRF01_AE아형위32%(22/69)、C아형위25%(17/69)、B아형19%(13/69).이곤명지구주요시08_BC아형60%(37/62)、CRF01_AE아형21%(13/62)화07_BC아형15%(9/62).결론 운남성덕굉、곤명량지구HIV-1류행독주pol구기인PR、RT기인돌변빈솔존재부분차이,곤명지구T215F/N/Y/I、M41L/M화T69G/N/I/S/A/D돌변솔고우덕굉지구.량지공검출HIV-1류행독주pol구기인CRF01_AE、B、C、BC、08_BC화07_BC공6충기인아형.
Objective To investigate the variations in the pol region of HIV-1 strain in treatment failed patients in Yunnan province's Dehong prefecture and Kunming. Methods Blood samples were collected from 139 patients who experienced treatment failure ( HAART treatment ＞ 1 years and HIV-1 RNA Viral load ＞ 1 000 copies/ml). HIV-1 RNA was extracted from plasma, and nested-PCR was performed for amplification of PR and RT genes on the HIV-1 pol region. The PCR products were then sequenced and submitted to Stanford HIV Drug Resistance Database for comparison. The evolution tree was built up with MEGA 4. 1 system, combined with patients' demographics. Results The most prevalent mutation in Kunming patients were T215F/N/Y/I, M41L/M, and T69G/N/I/S/A/D, the mutation rates were 39%(24/62), 27% (17/62) and 27% (17/62) , respectively, which were higher than the corresponding mutations in the Dehong prefecture [16% ( 11/69), 13% (9/69) and 9% (6/69)]. The rate differences were statistically significant ( x2 = 8.646, 4.242 and 7. 909, all P ＜ 0.05 ). The most common HIV-1 pol region subtype in the Dehong patients were CRF01_AE subtype (32%, 22/69), followed by C subtype (25% ,17/69), and B subtype ( 19%, 13/69). Major subtypes in Kunming patients were 08_BC (60%,37/62 ), CRF01_AE subtype(21% , 13/62 ) and 07_BC ( 15% ,9/62). Conclusions Partial differences of the point mutations of the HIV-1 strain pol region and frequency of their occurrences exist among Dehong and Kunming patients, HIV-1 strains in Dehong prefecture for the NNRTIs mutations at the T215 Y/N/T, M41L and T69G/N/I/S/A/D are significantly higher than those in Kunming. Six isoforms are found respectively:CRF01_AE, B, C, BC, 08_BC and 07_BC from the epidemic strains of HIV-1 pol region subtype in Dehong and Kunming areas.
