HIV感染者和艾滋病患者抗病毒疗效及耐药分析

Effect of anti-HIV treatment and drug-resistance HIV among infected persons and AIDS

目的研究浙江省宁波市HIV感染者和艾滋病人(HIV/AIDS)抗病毒治疗(HAART)效果和发生耐药情况。方法收集156例HIV-1型阳性病例血样,包括114例AIDS病人和42例未治疗感染者,检测CD4+T淋巴细胞数和HIV病毒载量,通过测序获得pol基因序列,经美国斯坦福大学HIV国际耐药数据库分析,获得毒株耐药情况。结果成功获得42例病例的pol序列;在HIV感染者中,HIV毒株对蛋白酶抑制剂分别有8例潜在耐药和2例中度耐药;在艾滋病人中,病毒载量低于最低检测限(50 IU/mL)的有100例,占87.7%;HIV毒株对核苷类和非核苷类抑制剂分别有4例和5例高度耐药;该人群的CD4+T淋巴细胞绝对数为14～1 060个/μL,平均为(314±28)个/μL。结论宁波市多数HIV感染者和艾滋病人对现有的抗病毒药物敏感,抗病毒治疗效果良好。

Objective To study the effect of anti-HIV treatment and status of drug-resistance among HIV /AIDS patients.Methods Whole blood samples were collected from HIV infected persons with or without anti-HIV treatment and AIDS patients.The absolute number of CD4＋ T lymphocyte and virus load of the subjects were detected.The virus RNA was amplified with nested-PCR and then sequenced.The drug resistance of HIV-1 strains isolated were obtained by comparison with Stanford HIV Drug Resistance Database.Results Forty-two sequences of pol gene were obtained.Drug resistance to PIs was detected,including 8 potential resistance and 2 intermediate resistance,in HIV infected persons without treatment.Drug resistance to NRTIs was detected,including 4 high-level resistance,and to NNRTIs was detected,including 5 high-level resistance,in AIDS patients.The mean value of absolute number of CD4＋ T lymphocyte was 314±28 /μL,with the lowest of 14/μL and the highest of 1 060/μL.Conclusion Most of HIV/AIDS patients are susceptible to the anti-HIV drug at present and a good treatment effect is achieved.