【摘要】：目的分析河北省不同感染途徑的HIV患者治療后基因突變情況及其相關(guān)影響因素。方法采集正在接受抗病毒治療的HIV患者血漿,采用基因型檢測法檢測HIV-1 pol區(qū)突變基因并分析其耐藥性。結(jié)果 266例患者中157例發(fā)生了基因突變,耐藥發(fā)生率59.0%。266例患者中高度耐藥發(fā)生率為NVP 65.8%(175/266)、3TC 41.7%(111/266)、F TC 4 1.7%(1 1 1/2 6 6)、E F V 3 0.1%(8 0/2 6 6)、D D I 5.6%(1 5/2 6 6)、D 4 T 4.1%(1 1/2 6 6)、A ZT 3.0%(8/2 6 6)、A B C3.0%(8/266)。經(jīng)血感染的HIV患者耐藥發(fā)生率高于性途徑和母嬰途徑,但χ2檢驗結(jié)果顯示這3種途徑之間在NNRTIs編碼區(qū)Y181C、K103N、V108I、K101E等主要突變位點(χ2=4.796,P=0.531),NRTIs編碼區(qū)M184V/I、M41L、T215F、T215Y(χ2=5.261,P=0.511),PIs編碼區(qū)A71V/T、L10I、M46L、Q58E(χ2=6.150,P=0.407)的差異均無統(tǒng)計學(xué)意義。OR值計算和95%CI分析表明,患者年齡、感染途徑、CD4+T淋巴細胞數(shù)、初始治療方案與HIV-1耐藥突變的發(fā)生存在顯著相關(guān)性(P0.05)。結(jié)論在HIV治療過程中應(yīng)適時進行CD4+T淋巴細胞、病毒載量和耐藥監(jiān)測,評估疾病進程,使引起耐藥的相關(guān)因素的影響降到最低,并及時更新治療方案。
[Abstract]:Objective to analyze the gene mutation and its related factors in HIV patients with different infection pathways in Hebei province. Methods the plasma samples of HIV patients undergoing antiviral therapy were collected. The mutation gene of HIV-1 pol region was detected by genotypic detection and drug resistance was analyzed. Results there was a gene mutation in 157 of 266patients. The incidence of high drug resistance in 59.0.266 patients was: NVP 65.8% (175p 266) 3TC 41.7% (111266) F TC 41.7% (11 / 26) E F V 30.1% (8 026.6) D D I 5.6% (1.5 / 266) D 4 T 4.1% (1,126.6) A ZT 3.0% (82.6%) A / C 3.0% (8 / 266). The incidence of drug resistance in patients with HIV through blood infection was higher than that in sex and mother and child. 浣喯，

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