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为了分析新余市HIV-1 CRF01-AE亚型的变异特征,了解其流行特性和最适抗逆转录病毒治疗方案,提高疗效,本文通过提取HIV毒株的RNA,巢式PCR扩增其env基因,产物经纯化测序,获得序列;对达到抗病毒治疗标准的HIV感染者,用不同治疗方案治疗至少6个月,并每隔3个月进行CD4+T淋巴细胞计数,获得治疗方案与疗效的关系。结果发现,经异性性接触感染的CRF01-AE亚型毒株间基因距离较大(0~47.4%),分为两大支,而同性性接触感染株较集中,基因距离小(0~2.6%);CRF01-AE亚型感染者合并乙肝、丙肝和梅毒感染率较高(56.3%);该型感染者经不同抗病毒治疗方案短期治疗后,CD4+T淋巴细胞水平都逐渐上升,但上升水平差异显著(p<0.05)。可见,HIV-1 CRF01-AE亚型毒株在传播过程中产生了各自的变异特征,且在新余市成为优势株而不断扩散,其感染者合并其它病毒感染率高,机会性感染大。HIV-1 CRF01-AE亚型毒株对治疗方案具有选择性,临床尽量选择最佳治疗方案,少用方案AZT+NVP+3TC,以提高疗效,降低机会感染率。
In order to analyze the variation characteristics of HIV-1 CRF01-AE subtype in Xinyu City, understand the epidemiological characteristics and the optimal antiretroviral therapy regimen and improve the curative effect, we amplified the env gene by extracting the RNA of HIV strains by nested PCR , The product was purified and sequenced to obtain the sequence; to HIV-infected patients who reached the standard of anti-virus treatment, with different treatment regimens for at least 6 months, and CD4 + T lymphocyte count every 3 months to obtain the treatment plan and efficacy relationship. The results showed that the genotypes of CRF01-AE subtypes infected by heterosexual contact were relatively large (0-47.4%), which were divided into two major branches, while the homosexual contact strains were more concentrated and the distance between genes was small (0-2.6 %). The infection rate of hepatitis B, hepatitis C and syphilis was higher in CRF01-AE subtype infected patients (56.3%). The levels of CD4 + T lymphocytes increased gradually after treatment with different antiviral treatment regimens There was significant difference between rising levels (p <0.05). It can be seen that HIV-1 CRF01-AE subtype strains have their own variation characteristics in the process of transmission, and become dominant strains in Xinyu City and continue to spread. The infection rate of other HIV-1 CRF01-AE strains is high, and opportunistic infections are large. The HIV-1 CRF01-AE subtype is selective for treatment options. The best treatment plan is to choose the best one and the less AZT + NVP + 3TC plan to improve the curative effect and reduce the opportunistic infection rate.