中国初治 HIV 感染者中传播的抗逆转录病毒药物耐药情况。
The prevalence of transmitted antiretroviral drug resistance in treatment-naive HIV-infected individuals in China.
机构信息
National Center for AIDS/STD Control and Prevention, Beijing, China.
出版信息
J Acquir Immune Defic Syndr. 2010 Feb;53 Suppl 1(Suppl 1):S10-4. doi: 10.1097/QAI.0b013e3181c7d363.
BACKGROUND
Transmission of HIV drug resistance (TDR) gives rise to reduced efficacy of initial antiretroviral treatment and has become a public health concern.
METHODS
A nationwide survey on TDR was conducted in antiretroviral therapy-naive HIV-1-infected individuals from September 2004 to October 2005 in China. Drug resistance genotyping was performed on subjects' plasma samples. Drug resistance mutations were determined and scored by Stanford HIV Drug Resistance algorithm.
RESULTS
Sequences were obtained from 676 individuals, of whom 61.2% were former plasma and blood donors, 17.3% were infected sexually, and 17.2% were intravenous drug users. Subtype B' HIV-1 strains were found in 73.5%, CRF01_AE in 13.9%, CRF07_BC in 6.2%, CRF08_BC in 2.7%, subtype C in 1.04%, subtype B in 0.9%, CRF02_AG in 0.4%, and B'/C intersubtype recombinant strains in 1.3% of the subjects. Twenty-six (3.8%) were found to harbor drug resistance strains. The rates of resistance to protease inhibitors, nucleoside reverse transcriptase inhibitors, and nonnucleoside reverse transcriptase inhibitors were 0.4%, 1.6%, and 2.1%, respectively. Though there was no significant difference in TDR rates between 2004 and 2005 (2.9% vs. 4.4%), an increased trend was observed in the rate of high-level drug resistance (0.8% in 2004 vs. 3.0% in 2005, P = 0.0634).
CONCLUSIONS
The rate of TDR was relatively low in China, as compared with those in developed countries. Surveys among recently HIV-infected subjects should be performed continually to ensure the success of the scale-up antiretroviral treatment.
背景
HIV 耐药性（TDR）的传播导致初始抗逆转录病毒治疗效果降低，并已成为公共卫生关注的问题。
方法
2004 年 9 月至 2005 年 10 月，在中国对接受抗逆转录病毒治疗的 HIV-1 感染的初治患者进行了全国性的 TDR 调查。对受试者的血浆样本进行耐药基因分型。采用斯坦福 HIV 耐药性算法确定耐药性突变并评分。
结果
从 676 名个体中获得了序列，其中 61.2%为既往血浆和献血者，17.3%为性传播感染，17.2%为静脉吸毒者。发现 B'型 HIV-1 株占 73.5%，CRF01_AE 占 13.9%，CRF07_BC 占 6.2%，CRF08_BC 占 2.7%，C 型占 1.04%，B 型占 0.9%，CRF02_AG 占 0.4%，B'/C 亚型重组株占 1.3%。26 例（3.8%）发现携带耐药株。对蛋白酶抑制剂、核苷逆转录酶抑制剂和非核苷逆转录酶抑制剂的耐药率分别为 0.4%、1.6%和 2.1%。虽然 2004 年和 2005 年 TDR 率无显著差异（2.9%比 4.4%），但高水平耐药率呈上升趋势（2004 年 0.8%比 2005 年 3.0%，P=0.0634）。
结论
与发达国家相比，中国的 TDR 率相对较低。应持续对新感染 HIV 的患者进行调查，以确保扩大抗逆转录病毒治疗的成功。
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