吉林省艾滋病抗病毒治疗人群基因型耐药研究

Research for genotype drug resistance and subtype distribution of AIDS antiviral treatment group

目的通过对艾滋病抗病毒治疗失败人群(治疗后血浆HIV-1病毒载量≥1 000拷贝/ml)进行病毒基因型耐药研究,观察治疗1年后病毒抑制效果和耐药性产生情况。方法采用核酸序列依赖性技术提取核酸,Inhouse方法进行巢式PCR扩增,对扩增产物进行序列测定,应用美国斯坦福大学HIV耐药数据库进行耐药分析。结果 2013年和2014年接受抗病毒治疗人群中病毒载量≥1 000拷贝/ml血浆样本116例和213例中,耐药发生率分别为37.1%(43/116)和41.3%(88/213),两年核苷类逆转录酶区耐药位点以M184V/IV等位点为主,非核苷类逆转录酶区耐药位点有G190G/AG/GS和V179D/E/DE/DV 2项突变,未发现蛋白酶区主要耐药位点。结论多数经过抗病毒治疗的艾滋病病人机体免疫功能逐步恢复,体内病毒得到有效抑制。但是随着治疗时间延长,病毒发生突变也随之增多。因此在保证抗病毒治疗效果的前提下,采取减少耐药毒株发生措施尤为重要。

Objective To observe the virus restraint effect and drug resistance production through the research of viral genotype drug-resistance of the failure group（ HIV-1 viral load in plasma = 1000 cps / ml after treatment） in AIDS antiviral treatment. Methods Nucleic acid was extracted by nucleic acid sequence dependency technology,In-house method was used to run nested PCR amplification,amplification product was determined in sequences,HIV drug resistance database of Stanford University was applied to process drug-resistance analysis. Results In 116 plasma cases of 2013 and 213 plasma cases of 2014 from patient group which received antiviral treatment with the viral load copies = 1000 cps / ml,drug resistance incidence rate was 37.1%（ 43 /116） and 41.3%（ 88 /213） respectively. In the two years,drug resistance sites of nucleoside reverse transcriptase region were major in M184 V / IV site,etc,two mutations in G190 G / AG / GS and V179 D / E / DE / DV of drug resistance sites of non-nucleoside reverse transcriptase region,major drug resistance sites of protease region had not found. Conclusion Immune function of majority AIDS patients recover gradually through antiviral treatment,virus count can be restrained effectively. But with the extension of the treatment time,virus mutation rises as well,therefore,it＇s fairly important to take measures to reduce the incidence of drug resistance strains in the context of assuring the effect of antiviral treatment.