HIV-1基因型、假病毒表型与活病毒表型耐药检测结果的比较

Comparison of genotype,pseusovirus phenotype and native virus phenotype of HIV-1 resistance

目的本研究旨在探讨HIV-1基因型、假病毒表型与活病毒表型耐药检测结果间的差异。方法采用逆转录和套式PCR方法检测4例HIV-1阳性患者逆转录酶与蛋白酶的编码区基因变异,并与假病毒表型及活病毒表型耐药检测结果相比较,分析三者间的差异。结果基因型耐药结果和活病毒表型耐药相比较存在不一致的情况,其中去羟肌苷:100%不一致,司他夫定:50%不一致,齐多夫定:25%不一致,依非韦伦和拉米夫定的结果 100%一致。假病毒与活病毒表型方法分别检测两株病毒对五种药物的表型耐药,共得到10个结果,其中9个结果在耐药解释及耐药程度上均高度一致,仅一株病毒对于齐多夫定的耐药结果存在程度上的差异(假病毒方法为中度耐药,而活病毒方法为高度耐药)。结论 HIV-1基因型与表型耐药检测结果存在差异,假病毒表型与活病毒表型耐药检测方法结果高度一致,存在替代活病毒方法的可能。

Objective To investigate the difference among HIV-1 genotype, pseudovirus phenotype and native virus phenotype resistance results. Methods The gene mutation in reverse transcriptase and protease coding region of HIV-1 positive patients was detected by reverse transcription and nested PCR. The difference among genotype resistance, pseudovirus phenotype and native virus phenotype results was compared and analyzed. Results There was discordance between genotype and native virus phenotype resistance： didanosine： 100%, 2＇-3＇-didehydro-2＇-3＇-dideoxythymidine： 50%, azidothymidine： 25%. It was 100% consistent for efavirenz and lamivudine. Pseudovirus and native virus phenotype resistance were detected in two strains for five kinds of drugs and the results were highly consistent. Conclusions There was difference between HIV-1 genotype and phenotype resistance results and high consistency between pseudovirus phenotype and native virus phenotype resistance results. The pseudovirus phenotype could be an alternative method for native virus phenotype.