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目的研究辽宁省未经抗病毒治疗的人类免疫缺陷病毒(HIV)感染人群中耐药突变的发生和流行情况。方法提取辽宁省91例HIV-1感染者外周血基因组DNA,巢式PCR方法扩增pol区蛋白酶基因全序列与逆转录酶基因部分序列,直接进行序列测定。序列拼接后,递交HIVdb-Drug Resistance Algorithm进行耐药性分析。结果3株毒株在蛋白酶编码区含有M46I变异,在蛋白酶编码区次要变异普遍存在,由高到低依次为L63P(60.4%)及V77I(60.4%)、M36I/V(31.9%)、A71V/T(22.0%)、L10I(8.8%)和K20R(6.6%)。1株毒株在逆转录酶编码区含有M184I变异。结论约4.4%的感染者对至少一种我国现有的抗病毒药物耐药。辽宁省未经抗病毒治疗的HIV-1感染人群绝大部分为抗病毒治疗敏感人群,但应加强监测,防止耐药株流行。
Objective To study the occurrence and prevalence of drug-resistant mutations in human immunodeficiency virus (HIV) -related individuals without HIV in Liaoning Province. Methods Genomic DNA was extracted from peripheral blood of 91 cases of HIV-1 infected persons in Liaoning Province. The complete protease gene sequence and the reverse transcriptase gene sequence were amplified by nested PCR and sequenced directly. After the sequence was spliced, the HIVdb-Drug Resistance Algorithm was submitted for drug resistance analysis. Results The three strains contained the M46I mutation in the protease coding region. The minor mutations in the protease coding region were common, ranging from high to low as L63P (60.4%) and V77I (60.4%), M36I / V (31.9%), A71V /T(22.0%), L10I (8.8%) and K20R (6.6%). One strain contained the M184I mutation in the reverse transcriptase coding region. Conclusion About 4.4% of the infected patients were resistant to at least one of our existing antiviral drugs. Most of the HIV-1-infected people in Liaoning Province without antiviral therapy are sensitive to antiviral therapy, but monitoring should be strengthened to prevent the spread of drug-resistant strains.