2004 年至 2009 年韩国接受高效抗逆转录病毒治疗的艾滋病毒/艾滋病患者中抗逆转录病毒药物多重耐药的流行情况。

The prevalence of antiretroviral multidrug resistance in highly active antiretroviral therapy-treated patients with HIV/AIDS between 2004 and 2009 in South Korea.

机构信息

Division of AIDS, Department of Immunology and Pathology, National Institute of Health South Korea, The Korea Centers for Disease Control and Prevention, Republic of Korea.

出版信息

J Clin Virol. 2014 Jun;60(2):154-60. doi: 10.1016/j.jcv.2014.02.004. Epub 2014 Feb 21.

DOI:10.1016/j.jcv.2014.02.004

PMID:24680255

Abstract

BACKGROUND

Highly active antiretroviral therapy (HAART) including protease inhibitors (PIs) has been used in South Korea since 1997. Currently, more than 20 types of antiretroviral drugs are used in the treatment of human immunodeficiency virus-infected/acquired immune deficiency syndrome patients in South Korea. Despite the rapid development of various antiretroviral drugs, many drug-resistant variants have been reported after initiating HAART, and the efficiency of HAART is limited by these variants.

OBJECTIVES

To investigate and estimate the annual antiretroviral drug resistance and prevalence of antiretroviral multi-class drug resistance in Korean patients with experience of treatment.

STUDY DESIGN

The amplified HIV-1 pol gene in 535 patients requested for genotypic drug resistance testing from 2004 to 2009 by the Korea Centers for Disease Control and Prevention was sequenced and analyzed annually and totally. The prevalence of antiretroviral drug resistance was estimated based on "SIR" interpretation of the Stanford sequence database.

RESULTS

Of viruses derived from 787 specimens, 380 samples (48.3%) showed at least one drug class-related resistance. Predicted NRTI drug resistance was highest at 41.9%. NNRTI showed 27.2% resistance with 23.3% for PI. The percent of annual drug resistance showed similar pattern and slightly declined except 2004 and 2005. The prevalence of multi-class drug resistance against each drug class was: NRTI/NNRTI/PI, 9.8%; NRTI/PI, 21.9%; NNRTI/PI, 10.4%; and NRTI/NNRTI, 21.5%.

CONCLUSIONS

About 50% and less than 10% of patients infected with HIV-1 have multidrug and multiclass resistance linked to 16 antiretroviral drugs, respectively. The significance of this study lies in its larger-scale examination of the prevalence of drug-resistant variants and multidrug resistance in HAART-experienced patients in South Korea.

摘要

背景

自 1997 年以来，韩国一直在使用包括蛋白酶抑制剂（PI）在内的高效抗逆转录病毒疗法（HAART）。目前，在韩国，有超过 20 种抗逆转录病毒药物用于治疗感染人类免疫缺陷病毒/获得性免疫缺陷综合征的患者。尽管各种抗逆转录病毒药物迅速发展，但在开始 HAART 后，已经报告了许多耐药变异体，HAART 的效率受到这些变异体的限制。

目的

调查和估计韩国接受过治疗的患者中每年的抗逆转录病毒药物耐药性和抗逆转录病毒多药耐药性的流行情况。

研究设计

韩国疾病控制与预防中心（KCDC）于 2004 年至 2009 年要求对 535 名患者进行基因型耐药性检测，对每年共检测的 HIV-1 pol 基因进行扩增并测序和分析。根据斯坦福序列数据库的“SIR”解释，估计抗逆转录病毒药物耐药性的流行情况。

结果

从 787 个标本中分离出的 380 个样本（48.3%）显示至少有一种与药物类别相关的耐药性。预测 NRTI 药物耐药性最高，为 41.9%。NNRTI 耐药率为 27.2%，PI 为 23.3%。除 2004 年和 2005 年外，每年的耐药率呈相似模式且略有下降。每种药物类别的多药耐药率分别为：NRTI/NNRTI/PI，9.8%；NRTI/PI，21.9%；NNRTI/PI，10.4%；NRTI/NNRTI，21.5%。