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目的对温州地区未治疗艾滋病(AIDS)病人体内艾滋病病毒(HIV)毒株耐药基因的突变情况进行调查分析,了解该地区AIDS病人的本底耐药情况。方法对50例未接受抗病毒治疗的AIDS病人HIVpol区的蛋白酶(PR)全长和部分反转录酶(RT)基因进行扩增、脱氧核糖核酸(DNA)测序、亚型鉴定,并与国际HIV耐药数据库比对分析。结果共获得38份有效序列,根据pol区亚型分析发现,CRF01_AE占36.8%(14例),CRF07_BC重组占36.8%(14例),C亚型占18.4%(7例),B亚型占7.89%(3例)。未检出针对蛋白酶抑制剂(PIs)、核苷类反转录酶抑制剂(NRTIs)的耐药病例。针对非核苷类反转录酶抑制剂(NNRTIs)检出3例耐药病例,突变类型分别为V179D、E138A和K103N。同时,2015年温州HIV耐药毒株的传播水平<5%,处于低传播水平。结论对于未经抗病毒治疗组,耐药基因型以CRF01_AE重组、BC重组为主,HIV耐药毒株在温州仍处于低度传播水平,发现一个重要耐药基因突变位点是K103N。
Objective To investigate the mutation of resistance gene of HIV in untreated AIDS patients in Wenzhou and to understand the background drug resistance in AIDS patients in the area. Methods Protease (PR) full length and partial reverse transcriptase (RT) genes of HIVpol region were amplified from 50 AIDS patients without AIDS virus. DNA sequencing and subtype identification were performed. HIV resistance database comparison analysis. RESULTS: A total of 38 valid sequences were obtained. According to pol subtype analysis, CRF01_AE accounted for 36.8% (14 cases), CRF07_BC 36.8% (14 cases), C subtype accounted for 18.4% (7 cases), B subtype 7.89% (3 cases). No cases of resistance to protease inhibitors (PIs) or nucleoside reverse transcriptase inhibitors (NRTIs) were detected. Three non-nucleoside reverse transcriptase inhibitors (NNRTIs) were detected in three cases of resistance, the mutation types were V179D, E138A and K103N. Meanwhile, in 2015, the transmission level of HIV-resistant strains of Wenzhou was <5%, which was at a low level of transmission. Conclusion In the non-antiviral treatment group, the resistant genotypes were mainly CRF01_AE recombinant and BC recombinant. The HIV-resistant strains were still at a low level of transmission in Wenzhou. The site of a major resistance gene mutation was K103N.