艾滋病45例病毒基因型耐药检测结果分析

Analysis on Results of Genotypic Viral Resistance Test in 45 Children with Acquired Immunodeficiency Syndrome

目的观察感染1型艾滋病病毒感染儿童应用高效抗反转录酶疗法治疗过程产生耐药后,行病毒基因型耐药检测对选择新治疗方案的作用。方法对各种治疗失败的艾滋病病例检测与病毒耐药显著相关的病毒反转录酶氨基酸排列突变点位,显示耐药情况。结果艾滋病40例采用一线药物治疗失败。其中14例(35%)出现对核苷类反转录酶抑制剂中原组合应用的齐多夫啶与拉米夫啶同时耐药,26例(65%)对齐多夫啶与拉米夫啶中一种耐药,原核苷类反转录酶抑制剂至少其中的一种仍可应用于新药组合中。对于非核苷类反转录酶抑制剂,11例(27%)对耐韦拉平耐药,29例(63%)对耐韦拉平与艾非那韦同时耐药。5例二线药物治疗失败中,2例中耐药检测结果显示在一、二线药物中各有一药未出现耐药,可在新药物组合中应用。结论基因型耐药检测技术的应用对选择最好的个性化的艾滋病治疗方案有重要意义。

Objective To observe the results of 45 cases with acquired immunodeficiency syndrome（AiDS） genotypic viral resistance test （GT） assay. Method The technitues provided by AB Applied Biosystem was used to check the mutations in the reverse transcriptase associated with significant viral resistance. Results Fourteen cases out of 40 （35 % ）cases which failed from first line regimen showed resistance to both zedovudine （ZDV） and lamivudine（LMV） , and 26 cases out of 40 （65 % ） cases showed resistance to ZDV or lamivudine used in the first line. For no -nucleoside reverse transcriptase in habitor（NNRTIs） , 11 cases oat of 40 （27%） cases had resistance to nevirapine （NVP） ,29 cases out of 40 （63%） cases showed resistance to both NVP and efairavir（EFV）. Two cases oat of 5 which failed from second line regimen showed that one drug from both first and second line had no resistance, so it still could be used in the new regimen. Conclusion GT assay is very useful for choosing a best and personalized regimen for AIDS patients.