阜新市高效抗反转录病毒治疗的HIV/AIDS病人基因型耐药情况及影响因素

Genotypic resistance and influencing factors of the patients with ART in Fuxin city

目的调查接受高效抗反转录病毒治疗(HAART)的艾滋病病毒(HIV)感染者/艾滋病(AIDS)病人(简称HIV/AIDS病人)基因型耐药的发生情况及其影响因素。方法收集HIV/AIDS病人血液样本和基本资料,并进行基因型耐药检测。采用Logistic回归模型分析病人发生基因型耐药的影响因素。结果获得可供分析序列的121例病人中,29例(23.97%)发生基因型耐药。Logistic回归分析表明,离婚或丧偶、治疗时间≥6年、病毒载量水平≥10000拷贝/mL[比值比(OR)=6.22,95%可信区间(CI):1.85~22.29]、(OR=9.92,95%CI:1.35~26.77)、(OR=14.85,95%CI:6.34~36.18)是HIV/AIDS病人发生基因型耐药的危险因素。而CD4^+T淋巴细胞(简称CD4细胞)≥600个/μL和服药依从性≥95%(OR=0.18,95%CI:0.05~0.981;OR=0.39,95%CI:0.267~0.68)是发生基因型耐药的保护因素。结论HAART后HIV/AIDS病人发生基因型耐药受多种因素影响,HAART过程中应加强患者CD4细胞数及病毒载量水平的监测,加强服药依从性教育,降低HIV/AIDS病人体内HIV耐药毒株的发生风险。

Objective To investigate the prevalence of genotypic resistance and its influencing factors in AIDS patients receiving anti-retroviral therapy(ART).Methods Blood samples and basic data of HIV-infected patients were collected and tested for genotypic resistance.Logistic regression model was used to analyze the influencing factors of genotypic resistance.Results Among the 121 patients with ART,genotypic resistance was detected in 29(23.97%)patients.Logistic regression analysis showed that divorce or widowhood,treatment duration≥6 years,and virus load≥10000 cp/ml were the risk factors of genotypic drug resistance in AIDS patients with OR 95%CI:6.22(1.85-22.29),9.92(1.35-26.77),14.85(6.34-36.18),respectively.CD4^+T lymphocytes≥600/μL and drug compliance≥95%were the protective factors,with OR 95%CI:0.18(0.05-0.981)and 0.39(0.267-0.68),respectively.Conclusion The occurrence of genotypic drug resistance in AIDS patients receiving ART is affected by many factors.We should strengthen the monitoring of CD4^+T lymphocytes and virus load during the treatment,strengthen the compliance education of medication,and reduce the risks of HIV resistant strains in the patients.