湖南省HIV-1耐药警戒线调查

Study on the threshold of HIV-1 drug resistance in Hunan province

目的了解湖南省开展艾滋病抗病毒治疗以来，年龄〈25岁新近感染HIV-1且未服抗病毒药者出现耐药毒株的变异情况。方法通过横断面调查，采集15～24岁HIV-1感染者的血清样本，进行HIV-1pol区耐药基因变异检测分析。结果69份有效样本中，在RT区1份样本出现可以导致针对NNRTIs系列的NVP、DLV和EFv药物的高度耐药性的K103N、V181C的2个主要耐药突变，1份样本出现可以导致对D4T的低度耐药性和对DDI的潜在耐药性的V75M耐药突变。PR区没有检测到高度耐药突变株。在RT区高度耐药株检出率为2．9％（2／69），说明湖南省HIV耐药株的传播仍处于低度范围内（〈5％）。结论表明现有的一线治疗方案是有效的，个体病例尚不需要在治疗开始前进行耐药性检测。但也提示应该加强对早期感染者的耐药监测工作。

Objective To survey the prevalence of HIV-1 drug resistance in patients newly diagnosed as HIV positive and who were younger than 25 years of age but had not received treatment with antiretroviral treatment （ART） in Hunan province. Methods Serum specimens of HIV infected individuals were collected and HIV-1 pol genetic mutations associated with drug resistance were identified with PCR and interpreted with Stanford HIV Drug Resistance Database. Results A total number of 69 patients whose HIV sequences were amplified successfully with 2 （2.9 % ） specimens appeared mutations associated with HIV-1 drug resistance in the reverse transcriptase region, including one as V75M and the other one as K103N and V181C. Data showed that the prevalence of drug resistance in Hunan was 2.9 %. Conclusion The first line regiments of national ART seemed still effective. Most of the AIDS patients did not need to be tested on drug resistance status before starting ART. However, it is important to start HIV drug resistance surveillance in no time.