某县HIV感染者基因型耐药检测分析

Analysis of Genotype Drug Resistance in HIV Infectors of One County in Henan Province

目的了解河南省某县H IV感染者蛋白酶和逆转录酶基因耐药性突变发生的情况。方法采集52例H IV感染者抗凝全血,用扩增/测序(In-House)的方法扩增蛋白酶及逆转录酶基因序列后进行序列测定,提交斯坦福耐药数据库分析耐药性突变。结果52感染者中41例成功扩增并测序,其中43.90%(18/41)发生耐药突变;蛋白酶区耐药突变发生率为36.59%(15/41),均为次要突变,突变类型依次为A71V(5/41),A71T(5/41),A71AT(3/41),A71AV(2/41)和L10I(2/41),第71位碱基突变率为36.59%(15/41);逆转录酶区耐药突变发生率为21.95%(9/41),为主要突变,突变类型主要为K103N(3/41),M41LM(2/41)和T215Y(2/41)。结论河南省确山县H IV感染者已发生较高程度耐药,应加强患者管理及耐药性监测体系,防止耐药毒株的传播。

Objective To investigate HIV infectors＇genotype drug resistance in Henan province. Methods 52 plasma samples were separated from the anticoagulatory whole blood, and In - House technique was used to detect the genotype drug resistance. The sequences were submitted to Stanford Drug Resistance Database to analye. Results Sequences of 41 samples were successfully amplified and analyzed. The mutation rate of drug resistance was 43.90% （ 18/41 ）. The minor mutation rate of resistance to protease was 36. 59%, including types of A71V （5/41）, A71T（5/41 ）, A71AT （3/41）, A71AV （2/41） and L10I （2/41）, The mutation rate of resistance to the 71th base was 36. 59% （ 15/41 ）. The major mutation rate of resistance to reverse transcriptase was 21.95%, mainly including types of K103N（3/41） ,M41LM（2/41） and T215Y（2/41 ）. Conclusion Most of HIV infectors in Queshan county Henan province were resistant to the currently available antiviral medicine. The system of antiviral management and survilliance should be adjusted to decrease the transmission of drug resistant virus.