SDF1-3’A基因多态性与河南汉族HIV-1感染者抗病毒治疗效果相关性研究

Study on the relationship between SDF1-3’A gene polymorphism and the effect of antiretroviral therapy in the Han group of HIV-1 infections in Henan

目的分析河南省部分地区汉族HIV-1感染者SDF1-3’A基因多态性特征及与抗病毒治疗效果相关性,探讨抗病毒治疗免疫学失败原因。方法募集2012-2014年河南省感染HIV-1并接受免费艾滋病抗病毒治疗病例,检测其治疗基线和治疗3年后CD4^(+)T淋巴细胞计数,按照免疫学治疗效果标准分为无效组(免疫学失败)和有效组;提取基因组DNA,获得SDF1-3’A基因片段并确定基因型,应用SHEsis在线分析软件进行Hardy-Weinberg平衡检验、基因型及等位基因频率分析;采用统计学方法比较不同情况下基因型及基因型频率与疗效的关系。结果共纳入研究对象208例,其中,无效组52例,有效组156例。SDF1-3’A位点在无效组中的AA基因型(15.4%vs 3.8%,加性模式P=0.005;隐性模式P=0.011)和A等位基因分布频率(31.7%vs 22.1%,P=0.048)高于有效组。在97例男性病例中,无效组(30例)AA基因型(16.7%vs 1.5%,P=0.010)及A等位基因分布频率(35.0%vs 20.9%,P=0.037)高于有效组,其治疗失败的风险较高(OR=14.286,95%CI:1.534~133.072;OR=2.038,95%CI:1.038~4.001)。在160例经血液途径感染病例中,AA基因型及A等位基因在无效组的分布频率高于有效组(18.6%vs 5.1%,P=0.007;36.0%vs 23.5%,P=0.025),其治疗失败的风险较高(OR=4.533,95%CI:1.407~14.607;OR=1.834,95%CI:1.076~3.129)。结论SDF1-3’A基因多态性与河南汉族艾滋病高效抗逆转录病毒治疗疗效有一定相关性,AA基因型及A等位基因可能是河南汉族人群抗病毒治疗失败的风险因素,且在男性及经血感染病例中更加明显。

Objective To explore genetic polymorphism of SDF1-3’A and the efficacy of antiretroviral therapy(ART)for HIV-1 infected Han people in some areas of in Henan province,to analyze the possible reasons inducing the immunological failure.Methods HIV-1 infections were recruited for initial ART in Henan during 2012-2014 and blood samples were collected for CD4 T lymphocyte counts at baseline and 3 years post ART in Henan province.According to the criteria for ART immunological failure,the cases were divided into failure group and effective group.The genomic DNA was extracted,SDF1-3’Agene segments were obtained by PCR to determine the genotype.The H-W(hardy-weinberg)balance test,genotype and allele frequency analyses were performed using SHEsis online software.The relationship between genotype and genotype frequency and efficacy was compared by statistical method.Results Totally,208 individuals were recruited,with 30 in failure group and 156 in effective group.The frequency of AA genotype of SDF1-3’A locus in the invalid group(15.4%vs 3.8%),additive mode P=0.005;The recessive mode(P=0.011)and A allele frequency(31.7%vs 22.1%,P=0.048)was significantly higher than that in the effective group.In 97 male patients,AA genotype(16.7%vs 1.5%,P=0.010)and a allele frequency(35.0%vs 20.9%,P=0.037)in the null group were significantly higher than those in the effective group,the risk of treatment failure was higher(OR=14.286,95%CI:1.534-133.072;OR=2.038,95%CI:1.038-4.001).Among 160 cases infected via blood,the frequency of AA genotype and A allele of SDF1-3’A in the invalid group was significantly higher than that in the effective group(18.6%vs 5.1%,P=0.007;36.0%vs 23.5%,P=0.025),which increased risk of ART failure(OR=4.533,95%CI:1.407-14.607;OR=1.834,95%CI:1.076-3.129).Conclusion The gene polymorphism of SDF1-3’A is related to the efficacy of ART in Henan HIV-1 infections.The AA genotype and A allele of SDF1-3’A are risk factors for failure of ART,especially in men and cases with blood transmitted infection.