论文部分内容阅读
目的:了解河南省HIV耐药性毒株的流行状况及其进化规律。方法:以河南省南部某乡未经抗病毒治疗的艾滋病患者(45人)以及经抗病毒治疗 3个月和 6个月的部分患者(分别为 118人和 124人)为研究对象,通过逐一访谈了解一般情况、服药方案、服药依从性及保障措施、抗病毒治疗前后的临床表现等,同时采集 14mlEDTA抗凝静脉血,检测CD4 /CD8细胞数、病毒载量及基因型耐药性。结果:抗病毒治疗 3个月和 6个月时,患者的病情好转率分别是 55. 1%和 50. 8%,CD4+T细胞数较未服药治疗的患者显著提高;耐药性毒株的流行率由未服药人群的13. 9%快速上升到服药 3个月的 45. 4%和服药 6个月的 62. 7%。还发现耐药性突变位点和突变的频次显著增加,服药 3个月时,耐药性突变位点集中在 103位、106位和 215位密码子;服药 6个月时,突变的位点大幅度增加,突变率超过 5%的位点有 15个。病毒耐药谱的变化表现为,首先快速出现对非核苷类逆转录酶抑制剂 (NNRTI)类药物(DLV、EFV和NVP)具有高度耐药性的毒株,在此基础上,陆续出现对核苷类逆转录酶抑制剂 (NRTI)类药物(AZT、DDI、D4T、DDC)具有低度和潜在耐药性的毒株。由于服用AZT、DDI和NVP,导致对NVP的高度耐药性毒株和对AZT、DDI低度耐药性毒株的广泛流行,还出现了对DLV、EFV、D4T、3TC
Objective: To understand the prevalence and evolution of HIV-resistant strains in Henan Province. Methods: A total of 45 AIDS patients without AIDS virus in a township of southern Henan Province and some patients who were treated with antiviral therapy for 3 and 6 months (118 and 124 respectively) Interviews to understand the general situation, medication programs, medication compliance and protection measures, before and after antiviral therapy clinical manifestations, while collecting 14mlEDTA anticoagulation venous blood, CD4 / CD8 cell count, viral load and genotypic drug resistance. Results: At 3 months and 6 months after antiviral therapy, the improvement rate of patients’ condition was 55.1% and 50.8% respectively. The number of CD4 + T cells was significantly higher than that of those without medication. The resistant strains The prevalence rate rose rapidly from 13. 9% of the non-medication population to 45.4% of the 3-month medication dose and 62.7% of the 6-month medication dose. Also found that the frequency of drug-resistant mutation sites and mutations increased significantly, taking drug 3 months, the drug-resistant mutation sites concentrated in 103, 106 and 215 codons; taking 6 months, the mutation site A substantial increase in the mutation rate of more than 5% of the 15 sites. The changes in the spectrum of virus resistance were characterized by rapid emergence of strains highly resistant to non-nucleoside reverse transcriptase inhibitors (NNRTIs) (DLV, EFV and NVP), and on the basis of these, Nucleoside reverse transcriptase inhibitor (NRTI) drugs (AZT, DDI, D4T, DDC) have low and potentially drug resistant strains. Due to the widespread use of AZT, DDI and NVP, leading to a highly resistant strain of NVP as well as to AZT, DDI low resistant strains, there have also been reports of DLV, EFV, D4T, 3TC