昆明地区艾滋初治病例感染、免疫及耐药情况调查

Investigations on the Infection,Immunity and Drug Resistance of Newly-treated Cases of HIV in Kunming

目的研究针对昆明地区艾滋初治病例感染、免疫及耐药情况进行调查研究,将临床特征及病毒学特征进行联合分析,为艾滋病治疗难易程度的判定及抗病毒精准医疗个体化方案的制定提供依据。方法选取初治HIV病例200例,于治疗前采集血液,进行HIV病毒载量、HCV病毒载量、HBV病毒载量、CD4+T淋巴细胞计数,血清白蛋白、ALT、AST、HIV分型及耐药等检测。结果昆明地区艾滋初治病例感染途径以异性传播为主,占比80.5%,MSM人群也占有一定比例(6.5%),青少年及老年人群占比25%。200例HIV初治病例CD4水平与HIV病毒载量负相关(r=-0.58,P<0.05),其中有83例发生机会性并发感染。艾滋初治病例HIV亚型以CRF08;C亚型占比最高(27.5%)。200例HIV初治人群中共有7例感染者检出耐药突变位点,原发耐药率为3.5%。结论昆明地区艾滋病传播出现了新特征,传播途径从静脉吸毒为主转变为以异性传播为主,MSM人群、青少年及老年感染人群占比增加。昆明地区HIV初治人群HIV亚型具有独特分布特点,免疫状态整体偏低,原发耐药率为3.5%。

Objective To investigate the infection,immunity,and drug resistance of newly-treated HIV cases in Kunming.The clinical characteristics and virological characteristics were jointly analyzed,so as to provide a basis to determine the ease of treatment and individualized solutions for antiviral precision treatment.Method The HIV-RNA,HCV-RNA,HBV-DNA,CD4 cell count,ALT,AST,Hb,PLT,ALB,HIV typing and resistance testing in 200 cases of newly-treated cases of HIV were detected before the therapy.Result The mainly infection route of newly-treated cases of HIV in Kunming was the heterosexual transmission,accounting for 80.5%,and MSM people also occupied a certain proportion(6.5%).Youth and seniors accounted for25%.CD4 level was negatively correlated with viral load in newly-treated cases of HIV in Kunming(r=-0.58,P<0.05),and 83 cases of them suffered from the opportunistic concurrent infection.HIV subtype had the highest proportion with CRF08;C subtype in newly-treated cases of HIV in Kunming(27.5%).A total of 7 infected persons were detected resistance mutation sites in 200 newly-treated cases of HIV in Kunming.Primary resistance rate was 3.5%.Conclusion New features of HIV spreading in Kunming have emerged.The route of transmission has changed from intravenous drug use to heterosexual transmission.Increasing proportion of MSM population,adolescents and the Elderly.HIV subtypes have unique distribution characteristics in Kunming.The overall immune status is low.Primary resistance rate is 3.5%.