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目的了解抗艾滋病病毒治疗患儿病毒学失败者的耐药突变特点。方法采集接受过高效抗病毒治疗患儿的血浆,对病毒载量≥1 000拷贝/ml者进行耐药基因型检测,将所得序列上传到斯坦福大学耐药数据库(http://hivdb.stanford.edu)进行对比分析。结果发生病毒学失败的有66例患儿,其中38例患儿出现了耐药突变,耐药发生率为57.58%(38/66)。逆转录酶抑制剂的耐药发生率(56.06%,37/66)明显高于蛋白酶抑制剂的耐药发生率(3.03%,2/66)。结论 HIV-1耐药突变是导致治疗失败的主要原因,在艾滋患儿开始抗病毒治疗之前进行基因型耐药检测是必要的,可为制定适用的抗病毒治疗方案提供数据。
Objective To understand the characteristics of resistance mutations in patients with virological failure of anti-HIV treatment. Methods The plasma of children with highly effective antiviral therapy was collected. The resistant genotypes were detected in patients with viral load ≥1 000 copies / ml, and the obtained sequences were uploaded to Stanford University Drug Resistance Database (http://hivdb.stanford. edu) for comparative analysis. Results There were 66 cases of virological failure, of which 38 cases of children with drug-resistant mutations, the incidence of resistance was 57.58% (38/66). The rates of resistance to reverse transcriptase inhibitors (56.06%, 37/66) were significantly higher than those of protease inhibitors (3.03%, 2/66). Conclusion Mutation of HIV-1 is the main reason leading to failure of treatment. It is necessary to detect genotypic drug resistance in HIV-infected children before antiviral treatment, which can provide data for the development of antiviral treatment programs.