2011—2012年广东省人类免疫缺陷病毒/获得性免疫缺陷综合征患者的耐药情况分析

In Guangdong Drug Resistance of Patients with Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome in 2011 and 2012

目的探讨2011—2012年广东省人类免疫缺陷病毒(HIV)/获得性免疫缺陷综合征(AIDS)患者的耐药情况。方法分别收集广东省2011-2012年接受抗病毒治疗满1年以上的患者血浆,检测HIV病毒载量,对病毒载量(VL)>1 000 Copies/ml患者行HIV-1基因分型及耐药位点检测,比较2011—2012年患者的病毒抑制情况、HIV-1基因亚型与感染途径分布、耐药突变的发生情况、治疗药物的耐药情况。结果 2012年治疗失败率明显低于2011年下降,差异有统计学意义(χ2=59.57,P<0.01);通过静脉吸毒、同性和异性性传播的感染患者主要为CRF01_AE亚型,而输血传播感染的患者为CRF01_AE及CRF02_AG亚型;2012年NRT区主要耐药位点M184I/V突变比例明显低于2011年,差异有统计学意义(χ2=6.37,P<0.05);2012年患者3TC、FTC、NVP耐药率均明显低于2011年,差异有统计学意义(χ2=6.97,P<0.05)。结论 2011—2012年广东省HIV/AIDS患者基因亚型以CRF01_AE为主,两年间各类药物主要耐药位点未发生变化;耐药突变是HIV耐药性产生的主要原因,2012年耐药率下降和耐药突变率相符。

Objective To investigate the characteristic of anti-HIV drug resistance of failure treatment HIV/AIDS patients in Guangdong Province in 2011 and 2012.Methods In Guangdong Province the plasma of Patients,who receive antiretroviral treatment for more than one year,were collected in 2012 and 2011.the detection of HIV virus load,the viral load（VL）and 1000cp/ml in patients with HIV-1 genotype and mutation detection.Viral suppression,HIV-1 genotype and distribution of infection,drug resistance,the occurrence of drug resistance of patients in 2012 were compared with 2011,Results In 2012 the failure rate was significantly lower than in 2011,the difference was statistically significant（χ^2=59.57,P〈0.01）;Gene subtype of patients infected through intravenous drug use,homosexual and heterosexual transmission is mainly CRF01_AE,and transfusion transmitted infections of patients with CRF01_AE and CRF02_AG subtype;main resistance loci M184I/V of NRT mutation in 2012 was significantly lower than that of in 2011,the difference was statistically significant（χ2=6.37,P0.05）;In 2012 resistant rates of 3TC、FTC、NVP were significantly lower than that in 2011,there were statistically significant differences（χ^2=6.97,P0.05）.Conclusion In 2011 and 2012 gene subtype of patients with HIV/AIDS is still CRF01_AE subtypes,primarily resistance loci of various types of drugs did not change in Guangdong.Resistance mutations are the main causes of HIV drug resistance,the declined rates of drug resistance were the same as mutation rate in 2012.