摘要
目的调查2009-2012年广西HIV-1感染者的耐药状况，同时探讨耐药与亚型的关系。方法在广西各地随机募集HIV／AIDS患者，提取患者血液样本的HIVRNA，逆转录后扩增pol基因并测序，使用在线分析工具Genotyping结合MEGA 5．03软件进行亚型分型，使用斯坦福大学的HIV耐药数据库确定耐药突变位点及药物耐受情况。结果获得196份pol区序列，其中接受抗病毒治疗样本103例（52．55％），未经治疗样本93例（47．45％）；亚型分布为95例CRF01-AE（48．47％）、88例CRF08_BC（44．90％）、12例CRF07_BC（6．12％）以及1例B亚型（0．51％）；接受抗病毒治疗患者耐药率为10．68％，未经治疗患者耐药率为7．53％；在196例研究对象中发现低度耐药14例，中度耐药3例，高度耐药4例；1例针对核苷类逆转录酶抑制剂（NRTIs）和非核苷类逆转录酶抑制剂（NNRTIs）发生二重耐药；不同类型药物耐药结果：蛋白酶抑制剂（PIs）、NRTIs、NNRTIs及整合酶抑制剂（INs）相关耐药率分别为6．63％、3．06％、11．22％、8．67％；CRF01_AE、CRF07_BC和CRF08_BC亚型发生PIs相关突变的频率分别为6．32％、41．67％和2．27％；A71V／T在CRF07_BC毒株中出现最多（75％），E138A仅出现在CRF08_BC毒株中（100％）。结论广西HIV-1患者耐药发生率高于全国水平，不同亚型HIV-1流行株的耐药发生率不同。
Objective To investigate the HIV-1 drug resistance in Guangxi during 2009 to 2012 and to analyze the correlations between drug resistance and HIV-1 subtypes. Methods Patients with human immunodeficiency virus infection or acquired immune deficiency syndrome （HIV/AIDS） were randomly recruited from different areas in Guangxi. HIV-1 RNA was extracted from blood samples of the subjects and converted into complementary DNA （eDNA） by using reverse transcription. The pol gene was amplified and sequenced. Subtyping analysis was performed by using the online analysis tool of Genotyping in combination with the MEGA 5.03 software. The HIV resistance mutations were determined and scored with the use of Stanford HIV Drug Resistance Database. Results A total of 196 pol gene sequences were obtained from 103 antiretroviral therapy （ART）-treated subjects （52.55%） and 93 ART- naive subjects （47.45%）. The 196 pol gene sequences were classified into four subtypes including CRF01_AE, CRF08_BC, CRF07_BC and B, accounting for 48.47% , 44.90% , 6.12% and 0.51% , respectively. The HIV drug resistance rates in subjects with and without ART were 10.68% and 7.53% , respectively. Among the 196 subjects, 14 cases showed low level of drug resistance, 3 cases showed moderate level of drug resistance and 4 cases showed high level of resistance. Only one case was resistant to both nucleoside reverse transcriptase inhibitors （ NR- TIs） and non-nucleoside reverse transcriptase inhibitors （NNRTIs）. The resistance rates of the 196 cases to protease inhibitor （PIs） , NRTIs, NNRTIs, and integrase inhibitors （INs） were 6.63%, 3.06% , 11.22% and 8.67%, respectively. The frequencies of PIs-related mutations in subtypes CRF01_AE, CRF07_BC and CRFO8_BC were 6.32%, 41.67% and 2.27%, respectively. Most of the PI-related A71V/T mutations were identified in strains belonging to subtype CRF07_BC, accounting for 75% of all A71V/T mutations found in the 196 strains. The NNRTI-related E138A mutations only appeared in strains belonging to subtype CRF08_BC. Conclusion The drug resistance rate among patients with HIV-1/AIDS in Guangxi was higher than the average level in China. The drug resistance rates varied with the subtypes of HIV-1 strains.
出处
《中华微生物学和免疫学杂志》
CAS
CSCD
北大核心
2015年第11期846-850,共5页
Chinese Journal of Microbiology and Immunology
基金
国家自然科学基金地区基金（81171624,81360259）
广西自然科学基金（2013GXNSFBA019166）
广西教育厅高校科技项目（2013ZD012）
广西医科大学青年基金（GxMuYsF201344）
