CAJ | 학술논문

目的分析2010—2013年四川省感染CRF01_AE和CRF07_BC亚型HIV-1毒株艾滋病患者的耐药情况.方法于2010年1月1日至2013年12月31日,以其间四川省正接受艾滋病抗病毒治疗6个月以上、HIV-1病毒载量>1 000拷贝/ml的患者为研究对象,各收集其血浆1.5 ml.采用自建基因型耐药检测方法进行HIV-1 pol基因区耐药检测,将发现HIV-1 pol基因区耐药的患者作为有效研究对象.本研究共成功测序1 213例患者的HIV-1 pol基因序列.采用χ2检验或Fisher确切概率法比较感染不同亚型HIV-1毒株患者的耐药情况.结果 1 213例成功测序患者中,558例(46.0%)的序列发生耐药突变,其中感染CRF01_AE亚型毒株患者为327例(58.6%),CRF07_BC亚型毒株为126例(22.6%),CRF08_BC亚型毒株为46例(8.2%),B亚型毒株为33例(5.9%),C亚型毒株为4例(0.7%), CRF02_AG亚型毒株为1例(0.2%),不详亚型毒株为21例(3.8%).对CRF01_AE和CRF07_BC亚型毒株分析耐药突变分析,L33、F116、L74、Q151和T69耐药突变仅在CRF01_AE中出现,A71、K43和Q58耐药突变仅在CRF07_BC中出现;核苷类逆转录抑制剂(NRTIs)和非核苷类逆转录酶抑制剂(NNRTIs)中,CRF01_AE亚型毒株高度耐药率均高于CRF07_BC、CRF08_BC、B亚型毒株,差异均具有统计学意义(P<0.05).结论四川省HIV-1耐药毒株主要以CRF01_AE、CRF07_BC亚型为主,且其耐药突变情况不同.
목적 분석2010—2013년사천성감염CRF01_AE화CRF07_BC아형HIV-1독주애자병환자적내약정황.방법 우2010년1월1일지2013년12월31일,이기간사천성정접수애자병항병독치료6개월이상、HIV-1병독재량>1 000고패/ml적환자위연구대상,각수집기혈장1.5 ml.채용자건기인형내약검측방법진행HIV-1 pol기인구내약검측,장발현HIV-1 pol기인구내약적환자작위유효연구대상.본연구공성공측서1 213례환자적HIV-1 pol기인서렬.채용χ2검험혹Fisher학절개솔법비교감염불동아형HIV-1독주환자적내약정황.결과 1 213례성공측서환자중,558례(46.0%)적서렬발생내약돌변,기중감염CRF01_AE아형독주환자위327례(58.6%),CRF07_BC아형독주위126례(22.6%),CRF08_BC아형독주위46례(8.2%),B아형독주위33례(5.9%),C아형독주위4례(0.7%), CRF02_AG아형독주위1례(0.2%),불상아형독주위21례(3.8%).대CRF01_AE화CRF07_BC아형독주분석내약돌변분석,L33、F116、L74、Q151화T69내약돌변부재CRF01_AE중출현,A71、K43화Q58내약돌변부재CRF07_BC중출현;핵감류역전록억제제(NRTIs)화비핵감류역전록매억제제(NNRTIs)중,CRF01_AE아형독주고도내약솔균고우CRF07_BC、CRF08_BC、B아형독주,차이균구유통계학의의(P<0.05).결론 사천성HIV-1내약독주주요이CRF01_AE、CRF07_BC아형위주,차기내약돌변정황불동.
Objective To investigate the drug resistance of HIV patients to the HIV-1 CRF01_AE and CRF07_BC strains in Sichuan province during 2010 to 2013. Methods 1.5 ml of plasma were collected from AIDS patients who had been receiving anti-retroviral treatment for over 6 months but still had a HIV-1 virus load of over 1 000 copies/ml from January 1, 2010 to December 31, 2013 in Sichuan province. Genetic analysis of the HIV-1 pol gene was performed using self-established method, and patients with a positive drug-resistant HIV-1 pol gene mutation were included. HIV-1 poly gene was successfully sequenced for a total of 1 213 patients. Drug resistance of different HIV-1 strains was compared withχ2 test or Fisher exact test. Results 558 cases (46.0%) of the 1 213 successfully sequenced patients were infected by HIV-1-strains with drug-resistant mutations, including 327 cases (58.6%) infected by CRF01_AE strain, 126 (22.6%) by CRF07_BC strain, 46 (8.2%) by CRF08_BC strain, 33 (5.9%) by B strain, 4 (0.7%) by C strain, 1 (0.2%) by CRF02_AG strain, and 21 (3.8%) by unidentified strains. Drug-resistant mutation analysis revealed that L33, F116, L74, Q151, and T69 resistance mutations occurred only in the CRF01_AE strain, while A71, K43, and Q58 resistance mutations occurred only in the CRF07_BC strain; in nuclear nucleoside reverse transcriptase inhibitors (NRTIs) and non nucleoside reverse transcriptase inhibitors (NNRTIs), CRF01_AE subtype strains showed highly resistant rate were higher than CRF07_BC, CRF08_BC and B subtype strains, with the differences were statistically significant (P<0.05). Conclusion The drug-resistant HIV-1 strains in Sichuan mainly included the CRF01_AE and CRF07_BC strains, which had different resistance mutations.