应用HIV-1耐药性基因型检测广东部分地区HIV耐药株

Application of drug-resistance genotyping of HIV-1 in investigating HIV drug resistant strains in selected areas of Guangdong Province

目的利用艾滋病病毒1型(HIV-1)耐药性基因型检测法,在HIV-1感染者中监测HIV-1耐药性病毒株,掌握广东省HIV-1感染者在利用抗病毒药物治疗前是否存在耐药突变及其流行情况。方法从未接受高效抗逆转录病毒联合疗法(HAART)治疗的HIV-1感染者血浆中提取病毒RNA,采用套式PCR扩增目的基因片断,并对扩增片断进行序列测定和分析。结果HIV-1耐药性基因型检测法能够从HIV-1感染者血浆病毒载量大于1 000拷贝/ml以上、CD4低于400以下的样本中扩增到目的片断。在广东省50例未治疗对象中,低中度耐药相关突变例数为2例,占4%;高度耐药相关突变例数为0;总耐药相关突变例数为2例,占4%。结论HIV-1耐药性基因型检测法能有效地监测HIV-1感染者血浆中的耐药性病毒株的存在,并且方法提供的结果准确、可靠。对广东省未接受抗病毒治疗的HIV-1感染者中耐药突变的检测表明,HIV-1感染者中存在病毒的耐药性突变,也反应了HIV毒株自然变异情况的存在。

Objective To apply HIV-1 genotyping in the surveillance of subjects infected with HIV-1 drug resistant strains,and to investigate if there are drug-resistant HIV-1 strains transmitted among infected subjects before antiretroviral therapy in Guangdong Province. Methods Viral RNA samples were collected from the sera of subjects infected With HIV- 1 without receiving HAART intervetion, and were amplified by nested PCR;then the amplified fragments were sequenced and analyzed. Result HIV-1 drug resistance genotyping can be applied in targeted gene fragments obtained from samples in which the viral load is more than 1000 copies/ml and CD4 is less than 400.Among 50 untreated cases,2 cases had low to median mutations associated with resistance, and the rate was 4 %, none of which had high mutations associated with resistance. Two cases had general mutations associated with resistance, with a rate of 4 %. Conclusion HIV-1 genotyping is an effective tool for the surveillance of HIV-1 drug resistant strains. These tests are accurate and reliable. The results of the study confirm the hypothesis that there are natural drug resistant mutants in the infected subjects even without receiving antiretroviral regimens.