陈琳, 潘晓红, 杨介者, 张佳峰, 郑锦雷, 徐云, 邢辉. 浙江省273名抗病毒治疗患者HIV-1毒株耐药性及其影响因素研究[J]. 疾病监测, 2010, 25(11): 869-873.
引用本文: 陈琳, 潘晓红, 杨介者, 张佳峰, 郑锦雷, 徐云, 邢辉. 浙江省273名抗病毒治疗患者HIV-1毒株耐药性及其影响因素研究[J]. 疾病监测, 2010, 25(11): 869-873.
CHEN Lin, PAN Xiao-hong, YANG Jie-zhe, ZHANG Jia-feng, ZHENG Jin-lei, XU Yun, XING Hui. Drug resistance of HIV-1 strain and its associated factors in 273 AIDS patients receiving antiretroviral therapy in Zhejiang province[J]. Disease Surveillance, 2010, 25(11): 869-873.
Citation: CHEN Lin, PAN Xiao-hong, YANG Jie-zhe, ZHANG Jia-feng, ZHENG Jin-lei, XU Yun, XING Hui. Drug resistance of HIV-1 strain and its associated factors in 273 AIDS patients receiving antiretroviral therapy in Zhejiang province[J]. Disease Surveillance, 2010, 25(11): 869-873.

浙江省273名抗病毒治疗患者HIV-1毒株耐药性及其影响因素研究

Drug resistance of HIV-1 strain and its associated factors in 273 AIDS patients receiving antiretroviral therapy in Zhejiang province

  • 摘要: 目的 了解浙江省抗病毒治疗患者HIV-1毒株耐药性及其影响因素。 方法 选择杭州市、宁波市、温州市为研究现场,以2009年底仍在抗病毒治疗且年满18岁的AIDS患者为研究对象,进行问卷调查和血液采集。对病毒载量1000 IU/ml的样本进行RT-PCR和巢式PCR扩增并测序,使用斯坦福大学HIVdb程序分析得到基因耐药结果。 结果 共273名研究对象纳入本研究分析。HIV-1毒株总耐药率为7.7%。职业为其他者、文化程度高者是预防耐药发生的保护性因素(OR=0.167、0.181),未婚或离异丧偶、治疗方案为D4T+DDI+NVP是耐药发生的危险性因素(OR=4.071、7.467)。 结论 浙江省抗病毒治疗患者耐药率处于低水平,但耐药突变多样化,应多关注文化程度低和无配偶者,尽早更改或停用D4T+DDI+NVP治疗方案,保持或提高服药依从性,可能有利于降低耐药毒株的发生。

     

    Abstract: Objective To investigate the prevalence of HIV-1drug resistance and related factors in AIDS patients receiving antiretroviral therapy in Zhejiang province. Methods The AIDS patients who were aged 18 years and received antiretroviral therapy till the end of 2009 in Hangzhou, Ningbo and Wenzhou were recruited in this study. The questionnaire survey and blood sample collection were conducted among them. The entire protease gene and part of the reverse transcriptase gene were amplified by RT-PCR and nest-PCR for the samples with viral load>1000 IU/ml, then the gene fragments were sequenced. Mutation of drug resistant gene and drug susceptibility were analyzed by the online tool HIVdb Program developed by Stanford University. Results A total of 273 subjects were enrolled in the analysis. The total drug resistance rate was 7.7%. Engaging in other occupation and having high education level were the protective factors (OR=0.167, 0.181). Being single/divorce/losing of spouse and receiving treatment of D4T+DDI+NVP protocol were risk factors (OR=4.071, 7.467). Conclusion The prevalence of HIV-1drug resistance in AIDS patients receiving antiretroviral therapy was low in Zhejiang, but the variety of drug resistant gene mutation was observed. More attention should be paid to the patients who were with low educated level or without spouse. It is necessary to stop D4T+DDI+NVP treatment as early as possible and remain or increase the patients compliance in order to reduce the emergence of drug resistant strain.

     

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