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目的:横断面了解浙江省未治疗人群耐药基因变异情况,补充耐药监测本底数据。方法:选取2004~2006年期间在各市县接受流行病学调查的104例未治疗HIV/AIDS感染者,对病毒载量高于最低检测限的99个样本进行HIV蛋白酶(PR)全长和部分逆转录酶(RT)基因区进行RT-PCR扩增测序。使用Stanford HIV Drug Resistance Database(ht-tp://hivdb.stanford.edu)的在线耐药序列分析软件HIV DB进行序列分析,寻找耐药相关突变位点,并做出样本对各药物敏感性的结论。结果:扩增得到74份PI区序列,1份样本存在蛋白酶抑制剂(PIs)主要相关突变,耐药突变率为1.35%;得到83份RT区序列,4份样本存在逆转录酶抑制剂(RTIs)相关突变,耐药突变率为4.8%。总耐药突变率为6.02%(5/83)。结论:浙江省未治疗HIV感染者中耐药相关突变处于低流行状态。但具体感染者体内存在的PR和RT区主要耐药突变位点,会导致对抗病毒治疗药物不同程度的耐药,应该争取条件对治疗前病人进行基因型耐药检测。
OBJECTIVE: To understand the variation of resistance gene in untreated population in Zhejiang Province and to complement the background data of drug resistance monitoring. Methods: A total of 104 untreated HIV / AIDS patients receiving epidemiological surveys in cities and counties from 2004 to 2006 were enrolled in this study. The total length of HIV protease (PR) and partial Reverse transcriptase (RT) gene region RT-PCR amplification of sequencing. Sequence analysis was performed using HIV DB, an online drug resistance sequence analysis software from the Stanford HIV Drug Resistance Database (ht-tp: //hivdb.stanford.edu), looking for resistance-related mutation sites and making the samples sensitive to each drug in conclusion. Results: 74 PI regions were amplified. One sample showed major related mutations of protease inhibitors (PIs) with a mutation rate of 1.35%. Eighty-three RT sequences were obtained, of which four were reverse transcriptase inhibitors RTIs) related mutations, the rate of drug-resistant mutation was 4.8%. Total resistance mutation rate was 6.02% (5/83). Conclusion: The resistance-related mutations in untreated HIV-infected persons in Zhejiang Province are in a low prevalence state. However, the main sites of resistance mutations in the PR and RT regions present in the infected patients will lead to different degrees of resistance to the anti-viral therapeutic drugs. Genotypic drug resistance testing should be conducted for the patients before treatment.