新疆274例HIV/AIDS抗病毒治疗耐药分析及两种耐药检测方法比较

Drug resistance analysis of antiviral therapy in 274 HIV/AIDS cases in Xinjiang and comparison of two methods for drug resistance detection

目的了解新疆维吾尔自治区目前HIV感染者的耐药率,分析其耐药位点特征。方法使用实验室自建的in-house HIV耐药检测方法和ViroSeqTM试剂盒分别对274例病毒载量大于1 000拷贝/毫升的感染HIV-1在治患者的血浆样本进行耐药检测,获得了样本的耐药状况和耐药位点信息,进一步分析样本耐药率和突变特征,并比较两种方法检测结果的一致性。结果 In-house HIV耐药检测结果发现17例(6.2%)样本出现蛋白酶抑制剂(proteaseinhibitors,PIs)耐药。70例(25.5%)样本检出对核苷类抑制剂(nucleoside reverse transcriptase inhibitors,NRTIs)耐药,119例(43.4%)样本检出对非核苷类抑制剂(nonnucleoside reverse transcriptase inhibitors,NNRTIs)耐药。PIs主要耐药突变位点为I84V和V82A;NRTIs类耐药突变中频率最高的位点为M184VI(49.2%);NNRTIs类耐药突变中K103N为主要突变位点(51.5%)。另外,两种耐药检测方法在PI类位点的一致性为94.5%,NRTI类位点一致性为98.5%,NNRTI类位点一致性为92.3%。结论本研究并未发现特殊的耐药位点。两种检测方法在检测结果方面一致性较高,in-house方法可以代替ViroSeqTM试剂盒以扩大HIV耐药检测覆盖面。

Objective To understand the drug resistance rate among HIV-infected people in Xinjiang Uygur Autonomous Region, and to analyze the characteristics of drug resistance sites. Methods Self-developed in-house HIV drug resistance testing method and ViroSeqTM kit were used to detect drug resistance in 274 HIV-1 patients receiving antiviral therapy and with viral load more than 1,000 copies/ml. The drug resistance status and drug resistance site information of the samples were obtained. The drug resistance rate and mutation characteristics of the samples were further analyzed, and the consistency of results detected by the two methods was compared. Results In-house HIV drug resistance testing displayed that 17(6.2%) samples showed resistance to protease inhibitors(PIs), 70(25.5%) samples resistance to nucleoside reverse transcriptase inhibitors(NRTIs), and 119(43.4%) samples resistance to non-nucleoside reverse transcriptase inhibitors(NNRTIs). The main drug-resistant mutations in PIs were I84 V and V82 A. The most frequent mutation in NRTIs was M184 VI(49.2%). The main mutation site in NNRTIs was K103 N(51.5%). In addition, the consistency of the two methods to detect PI, NRTI and NNRTI was 94.5%, 98.5% and 92.3%, respectively. Conclusions No specific resistance sites are found in this study. The consistency of results detected by the above-mentioned two methods is high. In-house HIV drug resistance testing method can replace ViroSeqTM kit to expand the coverage of HIV resistance detection.