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目的分析凉山州部分彝族人群2011年艾滋病病毒1型(HIV-I)在未治疗的感染人群中耐药毒株变异情况,为指导抗病毒治疗、评价治疗效果、合理调整治疗方案和制定应对措施提供依据。方法对129例25岁以下新确诊的HIV阳性血清样本,用In-house方法进行基因型耐药检测。共91例扩增测序成功,检测耐药传播相关的耐药突变,并分析其相关的亚型及其比例。结果 91例样本中,没有针对PR区的主要耐药性基因突变,但有7例样本存在针对RT区耐药性基因突变,4例为交叉突变(T215Y和V179E),3例为单一突变(T215Y、V179D和P225H),导致对齐多夫定(AZT)和司坦夫定(D4T)不同程度的耐药。RT区耐药株流行率为5.43%(7/129),属于中等流行水平(5%~15%)。91例样本中,CRF07-BCⅡ型所比例最大,达91.21%(83/91),B亚型仅占8.79%(8/91)。结论凉山州部分彝族人群未经抗病毒治疗的新发现HIV-1感染者中,已出现pol区耐药突变株,且传播水平达中度流行状态,需进一步加强抗病毒治疗患者的用药督导,提高其用药依从性,并持续性监测该地区抗病毒治疗人群的耐药情况。
Objective To analyze the variation of drug-resistant strains of HIV-I in some untreated infected population in some Yi people in Liangshan Prefecture in 2011. To guide the anti-virus treatment, evaluate the therapeutic effect, reasonably adjust the treatment plan and make countermeasures Provide evidence. Methods 129 cases of newly diagnosed HIV-positive serum samples under the age of 25 years were tested for genotype resistance by In-house method. A total of 91 cases of sequencing were successfully amplified, drug-resistant mutations were detected, and related subtypes and their proportions were analyzed. Results There were no major resistance mutations in PR region in 91 samples. However, seven of the 91 samples were resistant to mutations in the RT region, 4 were cross-mutations (T215Y and V179E) and 3 were single mutations T215Y, V179D and P225H), leading to varying degrees of resistance to zidovudine (AZT) and stanamifluvin (D4T). The prevalence of drug-resistant strains in RT zone was 5.43% (7/129), which was moderately epidemic (5% -15%). In 91 samples, CRF07-BCⅡhad the largest proportion, reaching 91.21% (83/91), B subtype accounting for only 8.79% (8/91). Conclusion Among the newly discovered HIV-1 infected patients in some Yi population of Liangshan Prefecture, there are pol mutant resistant strains and their transmission reaches a moderate epidemic level. Therefore, it is necessary to further strengthen the medication supervision of patients with anti-viral treatment, Improve drug adherence and continuously monitor the drug resistance of anti-virus treatment people in the area.