浙江省2004-2007年HIV-1亚型CRF01_AE流行毒株的基因型耐药分析

姚亚萍; 辛若雷; 徐云; 杨介者; 郭志宏; 潘晓红; 张佳峰; 廖玲洁; 邢辉

Abstract

姚亚萍,辛若雷,徐云,杨介者,郭志宏,潘晓红,张佳峰,廖玲洁,邢辉.浙江省2004-2007年HIV-1亚型CRF01_AE流行毒株的基因型耐药分析[J].Chinese journal of Epidemiology,2009,30(4):376-379

浙江省2004-2007年HIV-1亚型CRF01_AE流行毒株的基因型耐药分析

Genotypic drug-resistance of HIV-1 CRF01_AE in Zhejiang province,2004-2007

Received:September 24, 2008

DOI：

KeyWord: 人免疫缺陷病毒基因型耐药变异

English Key Word: Human immunodeficiency virus Genotypic drug-resistance Mutation

FundProject:

Author Name	Affiliation
YAO Ya-ping	Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China
XIN Ruo-lei	中国疾病预防控制中心性病艾滋病预防控制中心病毒免疫室
XU Yun	Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China
YANG Jie-zhe	Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China
GUO Zhi-hong	Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China
PAN Xiao-hong	Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China
ZHANG Jia-feng	Zhejiang Provincial Center for Disease Control and Prevention, Hangzhou 310051, China
LIAO Ling-jie	中国疾病预防控制中心性病艾滋病预防控制中心病毒免疫室
XING Hui	中国疾病预防控制中心性病艾滋病预防控制中心病毒免疫室

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Abstract:

了解浙江省HIV-1主要流行毒株CRF01_AE在治疗人群和未治疗人群中的基因型耐药变异情况。方法选取2004-2007年间收集的HIV感染者样本，对HIV蛋白酶(PR)全长和部分反转录酶(RT)基因区进行RT-PCR扩增测序。分析56个感染CRF01_AE重组亚型样本的序列，其中未治疗组43例，已治疗组13例。使用StanfordHIVDrugResistanceDatabase(http：//hivdb。stanford。edu)的在线耐药序列分析软件HIVDB进行序列分析，寻找耐药相关突变位点。结果未治疗组CD4+T淋巴细胞中位数为229个/mm3，病毒载量log10.中位数为3.41，存在基因型耐药突变率的发生(5/43，11.6%)，检出包括PR区第10、46、71位和RT区的第103、118位氨基酸的耐药相关突变；治疗组CD4+T淋巴细胞中位数为186个/mm3，病毒载量log10中位数为3.91，13例中有8例发生了基因型耐药变异(61.5%)。检出29个基因型耐药突变。耐药率较高且多表现为交叉耐药。结论浙江省未治疗的HIV感染者存在一定程度的基因型耐药突变；已开始治疗的HIV感染者基因型耐药突变发生率较高，而且交叉耐药现象广泛存在。

English Abstract:

study the genotypic drug-resistant mutation among treat-naive or treated patients infected with HIV-1 CRF01_AE in Zhejiang province during 2004-2007.Methods HIV-i pol amplicons (PR+RT) from 13 treated and 43 treat-naive patients were obtained by reverse transcription-polymerase chain reaction (RT-PCR).The sequences were analyzed for genotypic antiretroviral resistance through online tools (http：//hivdb.stanford.edu).Results The median count of CD44+ T lymphocytes in 43treat-naive patients was 229 cells/mm3 and the median log10 viral load was 3.41.Some drug-resistant mutations were seen in these samples including amino acid 10,46,71,in the genes of protease (PR) and 103,118,in the genes of reverse transcriptase (RT) whereas twenty-nine resistance mutations in the genes of PR and RT were obtained in the 13 treated patients (8/13,61.5% ).The high prevalence of drug-resistant mutations was observed in patients who had been receiving HAART (hight active antiretroviral therapy).Among them,cross drug resistance was dominant.Correspondingly,the median counts of CD44+ T lymphocytes and the log10 viral load were 186 cells/mm3 and 3.91.Conclusion There was a low prevalence of genotypic drug-resistant mutations in treat-naive patients,but higher drug-resistant mutation in treated patients.More attention should be paid to the transmission of drug-resistant HIV strains and the antiretroviral therapy recipe should be adjusted correspondingly for the development of ART drugs,intervention as well as clinical therapy programs.

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