摘要
目的分析艾滋病（AIDS）病人血浆与脑脊液中,艾滋病病毒I型（HIV-1）的病毒载量、基因耐药突变之间的关系。方法采集72例AIDS病人配对的血浆和脑脊液标本,检测HIV-1病毒载量,对接受抗病毒治疗（ART）超过48周、但病毒载量〉1000拷贝/mL的标本进行基因型耐药检测。结果 72例AIDS病人中,37例未接受ART,血浆和脑脊液的病毒载量分别为5.04（3.56~6.65）lg拷贝/mL和4.15（1.70~6.25）lg拷贝/mL,差异有统计学意义（Z=-3.314,P=0.001）。35名接受一线抗病毒药物治疗超过48周的病人,血浆和脑脊液中的病毒载量分别为1.69（1.69~6.49）lg拷贝/mL和1.70（1.70~4.34）lg拷贝/mL,两者差异无统计学意义（Z=-1.253,P=0.210）。治疗组与未治疗组病人血浆及配对脑脊液病毒载量之间均无显著相关性,治疗病人血浆和脑脊液中病毒载量检测结果不一致率为51.4%。产生耐药性是ART失败的一个主要原因,血浆和配对脑脊液中的耐药基因突变位点类型基本一致。结论未接受ART病人血浆中的HIV-1病毒载量高于脑脊液。ART失败的病人（接受治疗但血浆和/或脑脊液病毒载量仍〉50拷贝/mL）的血浆和脑脊液中,病毒载量检测结果存在较高的不一致率。ART失败外周血和中枢神经系统耐药突变基本一致。
Objective To analyze HIV-1viral load and resistance mutations of plasma and paired cerebrospinal fluid samples from AIDS patients.Methods Plasma and cerebrospinal fluid samples of 72 AIDS patients were examined for HIV-1viral load.The genotypic resistance was analyzed with patients who received antiretroviral treatment for over 48 weeks and whose viral loads were still higher than 1000copies/mL.Results In 72 AIDS patients,37 did not receive antiretroviral therapy.The HIV-1viral load in plasma and cerebrospinal fluid were 5.04（3.56~6.65）lg copies/mL and 4.15（1.70~6.25）lg copies/mL,plasma viral load was significantly higher than in CSF viral load（Z=-3.314,P=0.001）.Thirty five patients who received first-line antiretroviral treatment over 48 weeks,the plasma and cerebrospinal fluid viral load was 1.69（1.69~6.49）lg copies/mL and 1.70（1.70~4.34）lg copies/mL,the difference was not statistically significant（Z=-1.253,P=0.210）.There were no significant correlation between the HIV-1virus load of plasma and cerebrospinal fluid in each group.The inconsistent rate between plasma and cerebrospinal fluid viral load in treatment patients is 51.4%.Drug resistance is a major cause of antiviral treatment failure,resistant patterns of plasma and paired cerebrospinal fluid are basically identical.Conclusion The HIV-1viral load in plasma is significantly higher than that in cerebrospinal fluids in patient who did not receive antiretroviral therapy.There is a higher rate of inconsistencies in antiviral treatment failure patients（who received treatment but plasma and/or cerebrospinal fluid viral load is still 〉50 copies/mL）.The genotypic resistance patterns of plasma and cerebrospinal fluid in treatment failure patients are identical.
出处
《中国艾滋病性病》
CAS
北大核心
2015年第2期92-95,共4页
Chinese Journal of Aids & STD
基金
"十一五"国家科技重大专项课题(2012ZX10001002-002-011)~~
