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目的了解北京地区男男性行为人群(MSM)的艾滋病病毒(HIV)传播耐药流行状况。方法收集536例新诊断的HIV感染者基线耐药检测数据,包括266例急性或早期感染者和270例慢性感染者。比较两组患者在病毒亚型和主要传播耐药突变模式,以及对目前我国一线、二线抗病毒治疗药物的预测敏感性差异。结果 536名感染者中,CRF01_AE亚型占52.1%,B亚型占24.8%,CRF07_BC/CRF08_BC占21.6%,另外有1.3%的患者属于独特的重组形式。7.8%的患者带有一种以上的传播耐药突变,其中,蛋白酶抑制剂(PI)类药物相关的耐药突变流行率为6.2%,核苷类反转录酶抑制剂(NRTI)类药物相关的耐药突变流行率为0.9%,非核苷类反转录酶抑制剂(NNRTI)类药物相关的耐药突变流行率为1.7%。仅1例患者(0.2%)被预测对NRTI类药物中的阿巴卡韦(ABC)显著耐药,PI类药物的显著耐药率为0,依非韦伦(EFV)和奈韦拉平(NVP)的显著耐药率为1.3%。急性或近期感染者与慢性感染者相比,在传播耐药流行率、耐药突变模式及预测的药物敏感性上都没有显著差异。结论中国MSM的HIV感染者总体传播耐药率较低,但是PI类药物相关的耐药突变流行率相对较高,值得临床医生予以重视。
Objective To understand the prevalence of HIV transmission in men who have sex with men (MSM) in Beijing. Methods A total of 536 newly diagnosed HIV-infected patients were tested for baseline drug resistance data, including 266 patients with acute or early infection and 270 patients with chronic infection. The two groups of patients in the virus subtypes and the main transmission of drug-resistant mutation patterns, as well as the current first-line, second-line antiviral drugs predict the sensitivity difference. Results Among 536 infected patients, CRF01_AE subtype accounted for 52.1%, subtype B 24.8%, CRF07_BC / CRF08_BC 21.6%, and another 1.3% of patients were in a unique recombinant form. 7.8% of patients had more than one transmission-resistant mutation with a prevalence of 6.2% for protease inhibitor (PI) -based drug-resistant mutations and a correlation of nucleoside reverse transcriptase inhibitor (NRTI) -like drugs The prevalence of drug-resistant mutations was 0.9%. The prevalence of drug-resistant mutations associated with NNRTIs was 1.7%. Only one patient (0.2%) was predicted to be significantly resistant to abacavir (ABC) in NRTIs with a significant rate of 0 for PIs, EFV and NVP, The significant resistance rate was 1.3%. There were no significant differences in prevalence of transmission of resistance, patterns of drug-resistant mutations, and predicted drug sensitivities when compared to those who were chronically infected with acute or recent infections. Conclusion The overall transmission rate of HIV infection among MSM in China is low, but the prevalence of PI-related drug-resistant mutations is relatively high, which deserves clinicians’ attention.