桂林市2019-2023年HIV/AIDS患者抗病毒治疗失败后耐药情况分析
Characteristics of drug resistance in HIV/AIDS patients with antiretroviral treatment failure in Guilin city,2019-2023
蒋立立 1秦金勇 1苏慧 1马后君 1秦燕飞 1邓超1
作者信息
- 1. 桂林市疾病预防控制中心检验科,桂林 541001
- 折叠
摘要
目的 探究桂林市HIV/AIDS患者在抗病毒治疗(antiretroviral treatment,ART)失败后HIV-1耐药情况.方法 采集桂林市2019年1月至2023年12月接受ART时间≥1年且HIV病毒载量≥1000拷贝/ml的患者血浆样本,同时收集其人口学信息,进行HIV-1基因型亚型分析和耐药检测,以确定耐药突变位点及毒株对药物的敏感性.结果 共收集ART失败并成功扩增的患者样本766例,其中男性536例(69.97％,536/766),平均年龄为54岁;共检出8种HIV-1亚型,其中以CRF01_AE(80.55％,617/766)、CRF07_BC(11.10％,85/766)和 CRF08_BC(6.92％,53/766)为主.耐药分析结果显示,HIV-1耐药率为34.86％(267/766),对核苷类反转录酶抑制剂(nucleoside reverse transcriptase inhibitors,NRTIs)、非核苷类反转录酶抑制剂(non-nucleoside reverse transcriptase inhibitors,NNRTIs)和蛋白酶抑制剂(protease inhibitors,PIs)的耐药均有发生,其中以NRTIs/NNRTIs双重耐药(48.31％,129/267)和NNRTIs耐药(43.07％,115/267)为主.共检测到37个耐药突变位点,14 个 NRTIs 相关的突变位点主要包括 M184V/I(47.57％,127/267)、K65R(18.73％,50/267)、K70E/N/T/G/R(13.11％,35/267)等;18 个 NNRTIs 相关的突变位点主要包括 K103N/R(56.93％,152/267)、V179D/E/T(21.72％,58/267)、G190C/S/Q(17.23％,46/267)和 V106I/M(16.85％,45/267)等;5个PIs相关的突变位点以L10V/I突变率最高(3.00％,8/267).4种NRTIs相关、3种NNRTIs相关和1种PIs相关的耐药突变位点在不同亚型的流行率存在显著差异(P＜0.05).结论 桂林市H1V/A1DS患者抗病毒治疗效果良好,耐药发生率总体较低,但未来仍需加强监测,减少耐药株的传播.
Abstract
Objective To explore the HIV-1 drug resistance in patients with HIV/AIDS in Guilin city following the failure of antiretroviral treatment(ART).Methods Plasma samples were collected from patients in Guilin who had received ART for more than 1 year and had a HIV viral load greater than or equal to 1 000 copies/ml from January 2019 to December 2023,and demographic information was also collected for HIV-1 genotype subtype analysis and drug resistance testing to determine the resistance mutation loci and the susceptibility of the strains to drugs.Results A total of 766 patient samples with failed ART collection and successful amplification were collected,of which 536(69.97％,536/766)were male,with an average age of53years;a total of 8 HIV-1 subtypes were detected,with CRF01_AE(80.55％,617/766),CRF07_BC(11.10％,85/766)and CRF08_BC(6.92％,53/766)predominated.The drug resistance analysis showed that the HIV-1 drug resistance rate was 34.86％(267/766),including nucleoside reverse transcriptase inhibitors(NRTIs),non-nucleoside reverse transcriptase inhibitors(NNRTIs)and protease inhibitor(PI),with dual resistance to NRTIs/NNRTIs(48.31％,129/267)and NNRTIs resistance(43.07％,115/267)predominantly.A total of 37 resistance mutation sites were detected,14 NRTIs-associated mutation sites mainly included M184V/I(47.57％,127/267),K65R(18.73％,50/267),K70E/N/T/G/R(13.11％,35/267),etc.,and 18 NNRTIs-associated mutation sites mainly included K103 N/R(56.93％,152/267),V179D/E/T(21.72％,58/267),G190C/S/Q(17.23％,46/267),and V106I/M(16.85％,45/267),etc.;and 5 PIs-associated mutation sites was the highest with L10V/I mutation rate(3.00％,8/267).Conclusions HIV/AIDS patients in Guilin have shown favorable outcomes in antiviral therapy,with a relatively low overall incidence of drug resistance.However,it is essential to enhance surveillance to reduce the spread of drug-resistant strains in the future.
关键词
艾滋病病毒/抗病毒治疗/基因型耐药/耐药突变Key words
HIV/Antiretroviral treatment/Genotypic drug resistance/Drug resistance mutation引用本文复制引用
出版年
2024
NETL
NSTL
万方数据