摘要
目的探索艾滋病病毒(Human immunodeficiency virus,HIV)病毒载量<1 000拷贝/mL的病人的耐药情况,以及耐药对后期治疗效果的影响。方法从安徽、河南等7个地区选取97例病毒载量大于检测限,同时<1 000拷贝/mL的血浆样本,采用实验室自制(in house)方法扩增pol区的蛋白酶和反转录酶基因区,片段长度1.3kb,测得序列并经编辑后,提交至Stanford HIV Drug Resistance Database(http://hivdb.Stanford.edu),分析耐药位点与耐药程度。结果在耐药毒株出现的初期,非核苷类反转录酶抑制剂是主要耐药药物,特别是对其中奈韦拉平(Nevirapine,NVP)的耐药是导致病人耐药的主要因素。在病毒载量>150拷贝/mL<1 000拷贝/mL的病人中,随着治疗时间延长,其耐药位点增加,耐药谱扩大(耐受药物种类与>1 000拷贝/mL的治疗失败病人相似)。结论在条件允许的情况下,应关注病毒反弹早期还处于低病毒载量的病人,其耐药检测结果可以有效预测后期的治疗失败和耐药发生。
Objective To determine HIV drug resistance mutations in treated patients who had a low plasma viral load and to evaluate their subsequent impact on antiretroviral treatment. Methods Plasma samples in which viral load was detectable and less than 1 000 copies/mL were collected from seven regions in China. Viral genome was extracted, and the whole reading frame of protease and a part of reverse transcriptase gene （1.3kb） were amplified and sequenced by using an in-house HIV drug resistance genotyping method. HIV drug resistance mutations were i- dentified by comparing obtained sequences with the consensus B sequence, and then interpreted according to the al- gorithm of Stanford HIV Drug Resistance Database. Results Non-nucleotide reverse transcriptase inhibitor related resistance was the most common in samples with a low viral load, and contributed to resistance to Nevirapine in a strong manner. To patients with a viral load between 150 and 1 000 copies/mL, the longer the treatment duration, the more drug resistance mutations and hence the stronger drug resistance. Conclusion More attention should be paid to the patients with a low viral load. The detection of drug resistance in the patients at low level viremia and with regimen switching accordingly can prevent the treatment failure effectively.
出处
《中国艾滋病性病》
CAS
2012年第10期642-644,647,共4页
Chinese Journal of Aids & STD
基金
国家科技重大专项艾滋病和病毒性肝炎等重大传染病防治项目(2008ZX10001-004和2012ZX10001-002)
国家传染病重点实验室项目(2011SKLID102)~~
