摘要
目的分析凉山地区低病毒血症患者HIV-1 RNA和HIV-1 DNA基因型耐药的特点。方法采集2021年5月至2022年1月在四川省凉山彝族自治州某县接受ART 6个月以上且连续两次HIV-1 RNA在50至1000 copies/mL的HIV/AIDS患者的全血标本。分离血浆和血细胞,对血浆标本进行HIV-1 RNA基因型耐药检测,对血细胞标本进行HIV-1 DNA基因型耐药检测。比较HIV-1 RNA和HIV-1 DNA基因型耐药的特点。结果26例研究对象中,男性12例(46.2%),女性14例(53.8%);年龄中位数为31.5岁;HIV-1感染途径以异性性行为为主(61.5%);ART时间中位数为3.9年;治疗方案以2种NRTIs+1种NNRTIs为主(80.8%)。22例HIV-1 DNA样本的pol区基因扩增成功,8例HIV-1 RNA样本的pol区基因扩增成功,HIV-1 DNA的pol区基因扩增成功率高于HIV-1 RNA的pol区基因扩增成功率,且差异有统计学意义(χ^(2)=15.442,P<0.05)。在HIV-1 RNA和HIV-1 DNA样本中,M184(3/6)和K103(3/6)均是发生频数最高的耐药突变位点,EFV(5/6)和NVP(5/6)均是在NNRTIs中发生频数最高的耐药药物,ABC(3/6)、FTC(3/6)和3TC(3/6)均是在NRTIs中发生频数最高的耐药药物。结论针对凉山地区低病毒血症患者采用HIV-1 DNA基因型耐药检测较HIV-1 RNA基因型耐药检测的检出成功率更高,同时可以更早的发现耐药突变情况。
Objective To analyze the characteristics of HIV-1 RNA and HIV-1 DNA genotype resistance in patients with low viremia in Liangshan Prefecture.Methods Whole blood samples were collected from HIV/AIDS patients who received ART for more than 6 months and had HIV-1 RNA between 50 and 1,000 copies/mL for two consecutive times in a county of Liangshan Yi Autonomous Prefecture,Sichuan Province from May 2021 to January 2022.Plasma and blood cells were separated and tested for HIV-1 RNA genotypic resistance in plasma samples and HIV-1 DNA genotypic resistance in blood cell samples.The characteristics of HIV-1 RNA and HIV-1 DNA genotypic resistance were compared.Results Of the 26 subjects,12(46.2%)were male and 14(53.8%)were female.The median age was 31.5 years.The route of HIV-1 infection was mainly heterosexual sex(61.5%).The median duration of ART was 3.9 years and the treatment regimen was mainly two NRTIs+one NNRTIs(80.8%).The pol region gene amplification was successful in 22HIV-1 DNA samples and 8 HIV-1 RNA samples.The success rate of pol region gene amplification in HIV-1 DNA was higher than that in HIV-1 RNA,and the difference was statistically significant(χ^(2)=15.442,P<0.05).In both HIV-1 RNA and HIV-1 DNA samples,M184(3/6)and K103(3/6)were the most frequently occurring resistance mutation sites.EFV(5/6)and NVP(5/6)were the most frequently occurring resistance drugs in NNRTIs and ABC(3/6),FTC(3/6),and 3TC(3/6)were the most frequently occurring resistance drugs in NRTIs.Conclusion HIV-1 DNA genotype resistance detection is more successful than HIV-1 RNA genotype resistance detection in patients with low viremia in Liangshan and drug resistance mutations can be detected earlier.
作者
曹汴川
刘梅
蒋桃
余庆华
袁天茹
周仙
丁苹
郭明贤
黄永茂
黄富礼
CAO Bianchuan;LIU Mei;JIANG Tao;YU Qinghua;YUAN Tianru;ZHOU Xian;DING Ping;GUO Mingxian;HUANG Yongmao;HUANG Fuli(Department of Infectious Disease,the Affiliated Hospital of Southwest Medical University,Luzhou 646000,Sichuan,China;Antiviral Therapy Center,the First People's Hospital of YuexiCounty,Liangshan 616650,Sichuan)
出处
《中国艾滋病性病》
CAS
CSCD
北大核心
2022年第10期1183-1186,共4页
Chinese Journal of Aids & STD
基金
四川省科学技术厅科研课题(2020YFS0514)
四川省卫生健康委员会科研课题(20PJ139)。
