贵州省HIV抗病毒治疗病人群耐药基因突变研究

The Analysis on Mutation of Drug Resistance Gene in HIV Patients Treated with Antiviral Therapy

目的:研究贵州省经抗反转录病毒治疗的艾滋病毒感染者/艾滋病患者(HIV/AIDS)的人免疫缺陷病毒(Human Immunodeficiency virus,HIV)的反转录酶区和蛋白酶区耐药基因变异情况。方法:采集贵州省抗病毒治疗的感染者/艾滋病患者(HIV/AIDS)56例的血样,进行RNA核酸提取、采用套式反转录-聚合酶链反应(Reverse Transcription-Polymerase Chain Reaction,RT-PCR)扩增HIV-1 pol基因基因片段及基因测序,对所得结果登录美国斯坦福大学HIV耐药数据库进行在线分析确定耐药突变情况。结果:分析获得的44例目的基因片段,有24例发生基因突变。亚型分布为:17例AE亚型、15例BC亚型、10例C亚型及2例B亚型。逆转录酶抑制剂(reverse transcriptase inhibitors,RTIs)突变率和蛋白酶抑制剂(protease inhibitors,PIs)突变率分别为45.5%(20/44)和13.6%(6/44),其中核苷酸类逆转录酶抑制剂(nucleotide reverse transcriptase inhibitors,NRTIs)耐药突变发生率为34.1%(15/44),非核苷类逆转录酶抑制剂(non-Nucleoside reverse transcriptase inhibitors,NNRTIs)耐药突变发生率38.6%(17/44)。结论:贵州已经出现了针对NRTIs与NNRTIs高度耐药毒株,有必要对未进行抗病毒治疗的感染者进行耐药监测。

Objective： To study the mutations of drug resistance in the reverse transcriptase region and protease region of human immunodeficiency virus（ HIV） in HIV/AIDS patients treated with antiretroviral therapy in Guizhou province. Methods： 56 plasma samples were collected from HIV/AIDS patients treated with antiretroviral therapy in Guizhou,and extract RNA nucleic acid. Applied Reverse Transcription-Polymerase Chain Reaction（ RT-PCR） to amplify HIV-1 pol gene,gene fragment and gene sequencing. The sequences phylogenesis were analyzed by landing Stanford University HIV drug resistance database. Results： 44 cases of target gene fragments were analyzed,and 24 cases of gene mutation occurred. The subtype distribution was as following： 17 samples of subtype AE,15 samples of subtype BC,10 subtype C and 2 subtype B. The mutation rates of reverse transcriptase inhibitors（ RTIs） and protease inhibitors（ PIs） were 45. 5%（ 20/44） and 13. 6%（ 6/44） respectively. Among them,the rate of drug resistance mutation of nucleotide reverse transcriptase inhibitors（ NRTIs） was 34. 1%（ 15/44）,and that of non-Nucleoside reverse transcriptase inhibitors（ NNRTIs） was38. 6%（ 17/44）. Conclusions： Nucleoside inhibitors and non-nucleoside inhibitors double drug-resistant strains have emerged in Guizhou,so it is necessary to monitor the drug resistance of the patients without antiviral treatment.