2009 年病毒载量＞50 拷贝/ml 的治疗患者中 HIV-1 耐药的流行情况：一项法国全国性研究。
Prevalence of HIV-1 drug resistance in treated patients with viral load >50 copies/mL in 2009: a French nationwide study.
机构信息
INSERM, U 943, Paris, France.
出版信息
J Antimicrob Chemother. 2013 Jun;68(6):1400-5. doi: 10.1093/jac/dkt033. Epub 2013 Feb 12.
BACKGROUND
Surveillance of HIV-1 drug resistance in treated patients with plasma viral load (VL) >50 copies/mL.
METHODS
The protease and reverse transcriptase (RT) genes were systematically sequenced in samples from 756 patients with VL >50 copies/mL in 2009. The genotyping results were interpreted for each antiretroviral drug (ARV) by using the ANRS algorithm v21. Weighted analyses were used to derive representative estimates of percentages of patients. Prevalence rates were compared with those obtained in 2004 among patients with VL >1000 copies/mL.
RESULTS
Sequences were obtained for 506 patients. Sequencing was successful in 45%, 80% and 96% of samples with VL of 51-500, 501-1000 and >1000 copies/mL, respectively. Resistance or possible resistance to at least one ARV was observed in 59% of samples. Overall, 0.9% of samples contained viruses resistant to all drugs belonging to at least three drug classes. All resistance prevalence rates were significantly lower in 2009 than in 2004.
CONCLUSION
In France, where 86% of patients were receiving combination antiretroviral therapy in 2009, only 15.0% of patients had a VL >50 copies/mL, suggesting that only 8.9% of treated patients could potentially transmit resistant viruses. Only 0.08% of patients harboured viruses fully resistant to at least three antiretroviral drug classes. Further studies are needed to determine whether resistance continues to decline over time.
背景
对血浆病毒载量（VL）＞50 拷贝/mL 的治疗患者进行 HIV-1 耐药性监测。
方法
2009 年，对 756 例 VL＞50 拷贝/mL 的患者样本进行了蛋白酶和逆转录酶（RT）基因的系统测序。采用 ANRS 算法 v21 对每种抗逆转录病毒药物（ARV）的基因分型结果进行了解读。采用加权分析得出了具有代表性的患者百分比估计值。将患病率与 2004 年 VL＞1000 拷贝/mL 的患者获得的患病率进行了比较。
结果
获得了 506 例患者的序列。VL 为 51-500、501-1000 和＞1000 拷贝/mL 的样本中，测序成功率分别为 45%、80%和 96%。至少一种 ARV 发生耐药或可能耐药的比例分别为 59%。总体而言，0.9%的样本中含有对至少三种药物类别的所有药物均耐药的病毒。2009 年所有耐药率均显著低于 2004 年。
结论
在法国，2009 年 86%的患者接受联合抗逆转录病毒治疗，仅有 15.0%的患者 VL＞50 拷贝/mL，这表明仅有 8.9%的治疗患者可能传播耐药病毒。仅有 0.08%的患者携带对至少三种抗逆转录病毒药物类别的病毒完全耐药。需要进一步研究来确定耐药性是否会随着时间的推移继续下降。
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