河南省沈丘县抗病毒治疗者HIV耐药株流行状况调查

崔为国; 薛秀娟; 刘佳; 孙国清; 刘春华; 田随安; 王哲; 李韩平; 李敬云

Abstract

崔为国,薛秀娟,刘佳,孙国清,刘春华,田随安,王哲,李韩平,李敬云.河南省沈丘县抗病毒治疗者HIV耐药株流行状况调查[J].Chinese journal of Epidemiology,2013,34(3):218-220

河南省沈丘县抗病毒治疗者HIV耐药株流行状况调查

A CROSS-sectional study on the prevalence of HIV drug resistance in patients parking antiretroviral treatment in Shenqiu county，Henan province

Received:September 29, 2012

DOI：

KeyWord: 艾滋病病毒抗病毒治疗耐药

English Key Word: HIV Antiretroviral therapy Drug resistance

FundProject:河南省医学科技攻关计划省部共建项目(2011010016)；河南省创新型科技人才队伍建设工程

Author Name	Affiliation	E-mail
CUI Weiguo	Centerfor AlDS／STD Control and Prevention. Henan Provincial Center for Disease Control and Prevention. Zhengzhou 450016, China
XUE Xiujuan	Centerfor AlDS／STD Control and Prevention. Henan Provincial Center for Disease Control and Prevention. Zhengzhou 450016, China
LIU Jia	Centerfor AlDS／STD Control and Prevention. Henan Provincial Center for Disease Control and Prevention. Zhengzhou 450016, China
SUN Guoqing	Centerfor AlDS／STD Control and Prevention. Henan Provincial Center for Disease Control and Prevention. Zhengzhou 450016, China
LIU Chunhua	Centerfor AlDS／STD Control and Prevention. Henan Provincial Center for Disease Control and Prevention. Zhengzhou 450016, China
TIAN Suian	Centerfor AlDS／STD Control and Prevention. Henan Provincial Center for Disease Control and Prevention. Zhengzhou 450016, China
WANG Zhe	Centerfor AlDS／STD Control and Prevention. Henan Provincial Center for Disease Control and Prevention. Zhengzhou 450016, China	wangzhe@hncdc.corn.cn
LI Hanping	Institute of Microbiology and Epidemiology, Academy of Military Medical&ience
LI Jingyun	Institute of Microbiology and Epidemiology, Academy of Military Medical&ience	lijy@nic.bmi.ac.cn

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Abstract:

目的了解河南省沈丘县艾滋病长期治疗患者耐药情况.方法对沈丘县120例于2003年开始接受抗病毒治疗的艾滋病患者进行横断面研究,同时测定其病毒载量(VL)和CD4+T淋巴细胞计数,对VL＞1000 copies/ml的患者进行In-house方法基因型耐药检测.结果 120例患者中有114例获得VL数据,其中33例小于检测限(50 copies/ml),其余81例VL均值为lg(4.09±1.10)copies/ml.所有患者CD_{4<\sub>^{+<\sup>T淋巴细胞计数的均值为(377±218) cells/ml,其中64例(53.3％)均值＞ 350 cells/ml.67例患者检测基因型耐药性,成功测序的58例中有40例产生反转录酶抑制剂耐药(RTIs),核苷类反转录酶抑制剂(NRTIs)、非核苷类反转录酶抑制剂(NNRTIs)的耐药发生率分别为53.4％(31/58)、67.2％ (39/58).三种治疗方案耐药发生比例无差异,NRTIs、NNRTIs两类药物中齐多夫定、拉米夫定、奈韦拉平的耐药发生率较高,未发现蛋白酶抑制剂耐药.结论河南省沈丘县艾滋病患者耐药毒株流行较严重,应长期随访监测,及时优化治疗方案.}}

English Abstract:

Objective To understand the prevalence of drug resistance in AIDS patients who had been receiving HAART in a long run,in Shenqiu county,Henan province.Methods This crosssectional study included 120 HIV infected patients who began receiving ART (antiretroviral therapy) in 2003.Viral loads and CD4 +T cells counts were measured,and In-house drug resistance test was performed in VL ＞ 1000 copies/ml patients.Results 114 cases out of 120 patients had complete viral load data.Among them,33 cases having viral loads less than 50 copies/ml,and the remaining viral loads showed an average of lg (4.09 ± 1.10) copies/ml.The average of CD4+ T cell counts was (377 ±2 1 8) cells/ml,with 64 (53.3％) cases showing their CD4+ T cell counts higher than 350 cells/ml.In 67 patients,58 of them showed genotypic resistance,and 40 cases showed reverse transcriptase inhibitors (RTIs) resistance.The ratios of nucleoside reverse transcriptase inhibitors (NRTIs) and nonnucleoside reverse transcriptase inhibitors (NNRTIs) resistance were 53.4％ (31/58) and 67.2％ (39/58),respectively.There were no differences of drug resistance ratio in the three treatment programs.The highest drug resistance rates in NRTIs and NNRTIs were zidovudine,lamivudin,nevirapine.However,protease inhibitors (PIs) resistance variants were not found.Conclusion The prevalence of drug-resistant strains seemed to be high in Shenqiu country,Henan province.Long-term follow-up monitoring strategy should be developed to optimize the timely treatment programs.

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