抗病毒治疗艾滋病患者HIV-1耐药性影响因素

Factors correlated with HIV-1 drug resistance in patients with antiretroviral treatment

目的探讨抗病毒治疗艾滋病患者耐药性的影响因素。方法对114例接受抗病毒治疗的艾滋病患者进行问卷调查,提取人类免疫缺陷病毒-1（HIV-1）RNA,扩增pol基因并测序,分析HIV-1耐药性及其影响因素。结果获得86例患者的HIV-1pol序列,其中15例轻度以上耐药,耐药率为17.4%（15/86）。服药依从性为50%-90%的患者,耐药率高于服药依从性≥90%的患者（OR=8.591,P=0.030）;治疗1年-者,耐药率高于治疗时间〈1年者（OR=8.089,P〈0.030）;农民患者的耐药率高于其他职业和无业人员（OR=4.223,P=0.017）。结论抗病毒治疗时间、服药依从性和职业因素与耐药有关,服药依从性低于90%、抗病毒治疗1年-、职业为农民的患者耐药率较高。

Objective To understand factors correlated with HIV-1 drug resistance in patients with antiretroviral treatment.Methods Overall 114 AIDS patients under antiretroviral treatment（ART） were recruited in the study.A survey was conducted to collect information correlated with HIV-1 drug resistance.HIV-1 RNA was extracted from the plasma of the patients and the pol fragments was amplified and sequenced.The sequence was analyzed for HIV-1 drug resistance,and factors correlated with drug resistance were analyzed.Results HIV-1 pol sequences were obtained from 86 patients.Among them,15 harbored mutations related to low or higher level resistance,and the rate of resistance to ART was 17.4%（15/86）.Higher rates of resistance were found in the patients with ART compliance above 50% but less than 90% compared to that of 90% or higher（OR=8.591,P=0.030）.Higher drug resistant rates were also found in patients with ART treatment more than 1 year（OR=8.089,P〈0.030） and with an employment of farmer（OR=4.223,P=0.017）.Conclusion Compliance to ART,treatment time,and employment are correlated with antiretroviral resistance among AIDS patients.Drug resistance will occur more frequently in patients with ART compliance lower than 90%,receiving ART for more than one year,or employed as farmer.