中华预防医学杂志
中華預防醫學雜誌
중화예방의학잡지
CHINESE JOURNAL OF
2012年
11期
982-986
,共5页
孙晓光%林彬%苏生利%林琳%陶小润%钱跃升%康殿民
孫曉光%林彬%囌生利%林琳%陶小潤%錢躍升%康殿民
손효광%림빈%소생리%림림%도소윤%전약승%강전민
HIV%抗药性,病毒%突变%高效抗逆转录病毒治疗
HIV%抗藥性,病毒%突變%高效抗逆轉錄病毒治療
HIV%항약성,병독%돌변%고효항역전록병독치료
HIV%Drug resistance,viral%Mutation%Highly active antiretroviral therapy (HAART)
目的 了解2011年山东省抗病毒治疗艾滋病患者中HIV毒株耐药基因的变异情况.方法 于2011年5-10月采集山东省17个地级市758例正在接受抗病毒治疗且治疗时间超过6个月艾滋病患者的抗凝全血,对病毒载量大于1000拷贝/ml的样本进行HIV蛋白酶(PR)全长和部分逆转录酶(RT)基因的RT-PCR和巢式PCR扩增并进行基因序列测定,将序列提交斯坦福大学耐药数据库分析耐药相关突变位点及对各药物的敏感性.结果 病毒未抑制率为9.1％(69/758),共获得53份序列用于耐药基因型分析.23例患者的HIV毒株耐药基因发生突变,总耐药率为3.1％(23/742).核苷类逆转录酶抑制剂(NRTI)和非核苷类逆转录酶抑制剂(NNRTI)的耐药率分别为2.4％(18/742)和3.0％(22/742),此两类药物的最主要耐药突变位点分别为M184V和Y181C,未发现对蛋白酶抑制剂(PI)产生耐药的HIV毒株.在23例发生耐药基因突变的研究对象中,78.3％(18/23)的HIV毒株对NRTI产生耐药性,95.7％(22/23)的HIV毒株对NNRTI产生耐药性,73.9％( 17/23)的HIV毒株对NRTI和NNRTI双重耐药.结论 山东省抗病毒治疗艾滋病患者中HIV毒株耐药基因的变异尚处于较低水平,但耐药突变已呈现多样化.
目的 瞭解2011年山東省抗病毒治療艾滋病患者中HIV毒株耐藥基因的變異情況.方法 于2011年5-10月採集山東省17箇地級市758例正在接受抗病毒治療且治療時間超過6箇月艾滋病患者的抗凝全血,對病毒載量大于1000拷貝/ml的樣本進行HIV蛋白酶(PR)全長和部分逆轉錄酶(RT)基因的RT-PCR和巢式PCR擴增併進行基因序列測定,將序列提交斯坦福大學耐藥數據庫分析耐藥相關突變位點及對各藥物的敏感性.結果 病毒未抑製率為9.1％(69/758),共穫得53份序列用于耐藥基因型分析.23例患者的HIV毒株耐藥基因髮生突變,總耐藥率為3.1％(23/742).覈苷類逆轉錄酶抑製劑(NRTI)和非覈苷類逆轉錄酶抑製劑(NNRTI)的耐藥率分彆為2.4％(18/742)和3.0％(22/742),此兩類藥物的最主要耐藥突變位點分彆為M184V和Y181C,未髮現對蛋白酶抑製劑(PI)產生耐藥的HIV毒株.在23例髮生耐藥基因突變的研究對象中,78.3％(18/23)的HIV毒株對NRTI產生耐藥性,95.7％(22/23)的HIV毒株對NNRTI產生耐藥性,73.9％( 17/23)的HIV毒株對NRTI和NNRTI雙重耐藥.結論 山東省抗病毒治療艾滋病患者中HIV毒株耐藥基因的變異尚處于較低水平,但耐藥突變已呈現多樣化.
목적 료해2011년산동성항병독치료애자병환자중HIV독주내약기인적변이정황.방법 우2011년5-10월채집산동성17개지급시758례정재접수항병독치료차치료시간초과6개월애자병환자적항응전혈,대병독재량대우1000고패/ml적양본진행HIV단백매(PR)전장화부분역전록매(RT)기인적RT-PCR화소식PCR확증병진행기인서렬측정,장서렬제교사탄복대학내약수거고분석내약상관돌변위점급대각약물적민감성.결과 병독미억제솔위9.1％(69/758),공획득53빈서렬용우내약기인형분석.23례환자적HIV독주내약기인발생돌변,총내약솔위3.1％(23/742).핵감류역전록매억제제(NRTI)화비핵감류역전록매억제제(NNRTI)적내약솔분별위2.4％(18/742)화3.0％(22/742),차량류약물적최주요내약돌변위점분별위M184V화Y181C,미발현대단백매억제제(PI)산생내약적HIV독주.재23례발생내약기인돌변적연구대상중,78.3％(18/23)적HIV독주대NRTI산생내약성,95.7％(22/23)적HIV독주대NNRTI산생내약성,73.9％( 17/23)적HIV독주대NRTI화NNRTI쌍중내약.결론 산동성항병독치료애자병환자중HIV독주내약기인적변이상처우교저수평,단내약돌변이정현다양화.
Objective To investigate drug resistance status in patients with highly active antiretroviral therapy (HAART) in Shandong province.Methods A total of 758 patients were separated from the anticoagulatory whole blood during May and October in 2011.The entire protease gene and part of the reverse transcriptase gene were amplified by RT-PCR and nest-PCR in the samples with viral load larger than 1000 copies/ml,then sequenced the gene fragments.Mutation of drug resistant gene and drug susceptibility was analyzed by the online tool HIV db program developed by Stanford University.Results The rate of virologic failure in patients was 9.1％ ( 69/758 ).A total of 53 gene sequences that acquired were used for genotypic resistance analysis.A total of 23 patients were indicated drug resistance with the total of 3.1％ (23/742).Drug resistance rates of nucleotide reverse transcriptase inhibitor ( NRTI ) and non-NRTI (NNRTI) were 2.4％ (18/742) and 3.0％ (22/742),respectively,and the primary mutation types of drug resistance were M184V and Y181C for NRTI and NNRTI,with no resistance to protease inhibitor(PI).In the 23 patients indicated drug resistance,78.3％ (18/23) were NRTI resistance,95.7％ (22/23) were NNRTI resistance and 73.9％ (17/23) dual NRTI and NNRTI resistance.Conclusion The presence of drug resistant gene in HIV strains among AIDS patients with HAART in Shandong province was at low level,but mutation diversity was found in drug resistant gene.
