摘要
目的了解河南省沈丘县艾滋病长期治疗患者耐药情况。方法对沈丘县120例于2003年开始接受抗病毒治疗的艾滋病患者进行横断面研究，同时测定其病毒载量（vL）和cD4＋T淋巴细胞计数，对VL〉1000copies／ml的患者进行In．house方法基因型耐药检测。结果120例患者中有114例获得vL数据，其中33例小于检测限（50copies／m1），其余81例vL均值为lg（4．09±1．10）copies／ml。所有患者CD4＋T淋巴细胞计数的均值为（377±218）cells／ml，其中64例（53．3％）均值〉350cells／ml。67例患者检测基因型耐药性，成功测序的58例中有40例产生反转录酶抑制剂耐药（RTIs），核苷类反转录酶抑制剂（NRTIs）、非核苷类反转录酶抑制剂（NNRTIs）的耐药发生率分别为53．4％（31／58）、67．2％（39／58）。三种治疗方案耐药发生比例无差异，NRTIs、NNRTIs两类药物中齐多夫定、拉米夫定、奈韦拉平的耐药发生率较高，未发现蛋白酶抑制剂耐药。结论河南省沈丘县艾滋病患者耐药毒株流行较严重，应长期随访监测，及时优化治疗方案。
Objective To understand the prevalence of drug resistance in AIDS patients who had been receiving HAART in a long run, in Shenqiu county, Henan province. Methods This cross- sectional study included 120 HIV infected patients who began receiving ART （antiretroviral therapy） in 2003. Viral loads and CD4 ＋T cells counts were measured, and In-house drug resistance test was performed in VL〉 1000 copies/ml patients. Results 114 cases out of 120 patients had complete viral load data. Among them, 33 cases having viral loads less than 50 copies/ml, and the remaining viral loads showed an average of lg （4.09±1. 10） copies/ml. The average of CD4＋ T cell counts was （377 ±218） cells/ml, with 64 （53.3%） cases showing their CD4＋ T cell counts higher than 350 cells/ml. In 67 patients, 58 of them showed genotypic resistance, and 40 cases showed reverse transcriptase inhibitors （RTIs） resistance. The ratios of nucleoside reverse transcriptase inhibitors （NRTIs） and non- nucleoside reverse transcriptase inhibitors （NNRTIs） resistance were 53.4% （31/58） and 67.2% （39/ 58）, respectively. There were no differences of drug resistance ratio in the three treatment programs. The highest drug resistance rates in NRTIs and NNRTIs were zidovudine, lamivudin, nevirapine. However, protease inhibitors （PIs） resistance variants were not found. Conclusion The prevalence of drug-resistant strains seemed to be high in Shenqiu country, Henan province. Long-term follow-up monitoring strategy should be developed to optimize the timely treatment programs.
出处
《中华流行病学杂志》
CAS
CSCD
北大核心
2013年第3期218-220,共3页
Chinese Journal of Epidemiology
基金
河南省医学科技攻关计划省部共建项目（2011010016）
河南省创新型科技人才队伍建设工程
关键词
艾滋病病毒
抗病毒治疗
耐药
HIV
Antiretroviral therapy
Drug resistance
