摘要
目的分析吉林市HIV感染者中HIV-1型对常用治疗药物的基因型耐药情况。方法采集吉林市接受抗病毒治疗的HIV-1感染者血样,提取RNA,采用巢式PCR法扩增HIV-1基因,利用ABI 3100测序仪进行核苷酸序列测定;用Sequencher 4.9对测定的序列拼接,用Bioedit软件进行多序列比对及序列清理后,与Stanford HIV Drug Resistance Database中的参考株序列进行比较,分析耐药基因突变及耐药结果。结果 49名HIV感染者中发现27人耐药,耐药率55.1%。检测出反转录酶(RT)区耐药突变位点8个,其中核苷类反转录酶抑制剂(nucleoside reverse transcripase inhibitors,NRTIs)类中,15例M184V和3例M41L突变,对应拉米夫定(Lamivudine,3TC)/恩曲他滨(Emdtricitabine,FTC)耐药15例和齐多夫定(Zidovudine,AZT)/司他夫定(Stavudine,D4T)耐药7例;非核苷类反转录酶抑制剂(non-nucleoside reverse transcripase inhibitors,NNRTIs)类中,13例K103N、8例V106I、6例Y181C及4例P225H突变,对应奈韦拉平(Nevirapine,NVP)耐药26例、依非韦伦(Efavirenz,EFV)耐药25例和利匹韦林(Rilpivirine RPV)耐药14例。蛋白酶(PR)区仅发现次要耐药突变(A71V/T/I和L10I/V),未造成相应药物的耐药。结论吉林市HIV感染者中耐药率较高,应加强耐药监测,拟定患者个性化治疗方案。
Objective To analyze the resistance of patients with human immunodeficiency virus（HIV）-1 infection to the drugs for routine therapy in Jilin City,Jilin Province,China. Methods Blood samples of patients with HIV-1 infection, receiving antiviral therapy in Jilin City,were collected,from which RNAs were extracted for amplification of HIV-1 gene by nested PCR. The nucleotides of amplified products were sequenced by ABI 3100 sequencer,spliced by Sequencher 4. 9 software,then subjected to BLAST by using Bioedit software,and the results were compared with those of reference strains in Stanford HIV Drug Resistance Database,based on which the drug-resistant gene mutation and drug-resistance were analyzed. Results Drug-resistance was found in 27 of 49 patients,with a resistance rate of 55. 1%. Eight mutation sites were detected in the reverse transcriptase（RT）region,corresponding to resistances to nucleoside reverse transcriptase inhibitors（NRTIs）and non-nucleoside reverse transcriptase inhibitors（NNRTIs）respectively. Mutations of M184V were observed in 15,while M41L in 3 of the patients with resistances to NRTIs,causing 15 cases of resistance to Lamivudine（3TC） / Emdtricitabine（FTC） and 7 cases to Stavudine（D4T）. Meanwhile,mutations of K103N were observed in 15,V106I in 8,Y181C in 6 and P225H in 4 of the patients with resistances to NNRTIs,causing 26 cases of resistance to Nevirapine（NVP）,25 cases to Efavirenz（EFV） and 14 cases to Rilpivirine（RPV）. However,only minor resistant mutations（A71V / T / I and L10I / V） were observed in protease region（PR）,which caused no resistances to the corresponding drugs. Conclusion High drug-resistance rate was observed in patients with HIV-1 infection in Jilin City. The drug-resistance surveillance should be reinforced to modulate the individual therapeutic protocol for patients.
出处
《中国生物制品学杂志》
CAS
CSCD
2014年第5期676-678,683,共4页
Chinese Journal of Biologicals
关键词
艾滋病病毒
基因型
耐药性
Human immunodeficiency virus（HIV）
Genotype
Drug-resistance
