河南省某市HIV感染者基因型耐药横断面调查

Cross sectional study of genotype drug-resistance mutation in HIV infected individuals in Henan

目的了解河南省某市HIV耐药毒株在HIV／AIDS患者中的情况。方法采集2011年河南省某市150份HIV／AIDS患者血清，提取RNA，逆转录及巢式PCR扩增HIV-1pol基因区。所得序列构建系统进化树分析亚型；并利用StanfordHIVDrugResistanceDatabase分析HIV基因耐药相关突变和耐药情况。结果150份样本中34份测序阳性，其中未接受抗病毒治疗样本9份，接受抗病毒治疗样本25份；B＋亚型占94．1％。测序阳性样本的基因突变率为58．8％，其中未接受抗病毒治疗的突变率为5．9％，接受抗病毒治疗的突变率为52．9％。结论接受抗病毒治疗的耐药样本中出现了对反转录酶抑制剂不同程度的耐药及多药耐药，说明仍需加强耐药监测及管理，尽量减少耐药株的产生，并根据耐药检测结果及时调整治疗方案。

Objective To find the prevalence of genotype drug-resistance mutation in HIV/AIDS infected individuals in Henan. Methods Totally 150 plasma samples were collected for RNA extraction from HIV/AIDS infected individuals in Henan in 2011. The HIV-1 pol gene region was amplified by the methods of reverse transcription and nested-PCR. The phylogenetic tree was constructed based on DNA sequences, and HIV genotype drug-resistance mutation was analyzed. Results Thirty-four of 150 plasma samples were successfully sequenced （9 in untreated group and 25 in antiretroviral therapy group）. HIV-1 elade B＇ was major genetic subtype, which accounted for 94. 1% respectively. The percentage of HIV genotype drug- resistance samples in sequenced samples was 58.8% （5.9% in untreated group and 52. 9% in antiretroviral therapy group）. Conclusion The samples with genotypie resistance in antiretroviral therapy group showed resistance to RT inhibitors incoordinately and multidrug resistance. Monitoring and management system of drug resistance should be improved. Treatment should be tried to reduce the generation of HIV drugresistance strains. And adjustment of the drug scheme should be in time.