Analysis of transmissible drug resistance in 120 HIV-1 patients from 2021 to 2022
2021-2022年120例HIV-1感染者传播性耐药情况分析

摘要

目的 了解本地区HIV感染者和艾滋病患者（AIDS）在初次抗病毒治疗前出现耐药的情况，即传播性耐药，为新发感染HIV患者在选择抗病毒治疗药物时或抗病毒治疗失败者提供参考。方法 采用PCR-电泳测序法，对2021年至2022年临汾市第三人民医院的120例HIV/AIDS血样进行基线HIV-1耐药测序检测，根据该120人份基因型耐药检测报告，分析其基因突变位点和耐药类别。结果 120例中，有19例出现传播性耐药现象，占到15.8%，突出表现在K103N、V106I、M184V位点发生突变；非核苷类反转录酶抑制剂（NNRTIs）耐药17人，占89.47%；同时对核苷类反转录酶抑制剂（NRTIs）和非核苷类反转录酶抑制剂（NNRTIs）耐药者2人；蛋白酶抑制剂类（PIs）耐药者1人，且为潜在耐药（P）。与同期的18例获得性耐药者相比较，获得性耐药的突变位点更多、耐药率和耐药程度更高。结论 目前初次抗病毒治疗前耐药已经出现较高比例，尤其是NNRTIs类药物传播性耐药情况普遍，抗病毒药物的病毒有效抑制率和治疗失败势必会受到大的影响，关注耐药流行形势，积极进行传播性耐药检测，选择敏感药物治疗，才能达到有效治疗目的。这些耐药性突变与抗病毒治疗的疗效和病毒传播密切相关。本研究为制定有效的抗病毒治疗方案和预防控制策略提供重要依据。

Abstract

Objective To understand the prevalence of drug resistance in HIV-infected and AIDS patients in this region before initial antiviral therapy, that is, transmissible drug resistance, and to provide reference for newly infected HIV patients when choosing antiviral therapy or failure in antiviral therapy.
Methods Baseline HIV-1 drug resistance detection was performed by PCR-electrophoresis sequencing in 120 blood samples of HIV/AIDS from the Third People's Hospital of Linfen from 2021 to 2022. The mutation sites and drug resistance categories of the 120 samples were analyzed according to the genotypic drug resistance test reports.
Results Among the 120 cases, 19 cases (15.8%) showed the phenomenon of transmissible drug resistance, especially the mutation of K103N, V106I and M184V. Non-nucleoside reverse transcriptase inhibitors (NNRTIs) were resistant in 17 patients (89.47%). Two patients were resistant to both nucleoside reverse transcriptase inhibitors (NRTIs) and non-nucleoside reverse transcriptase inhibitors (NNRTIs). Protease inhibitor (PIs) drug resistant in 1 person, and potential drug resistant (P). Compared with 18 cases of acquired drug resistance in the same period, the acquired drug resistance had more mutation sites, higher drug resistance rate and higher degree of drug resistance.
Conclusion   At present, there is a high proportion of drug resistance before initial antiviral treatment, especially the spread of drug resistance of NNRTIs, and the effective viral inhibition rate and treatment failure of antiviral drugs are bound to be greatly affected. Only by paying attention to the epidemic situation of drug resistance, actively carrying out the spread of drug resistance detection, and selecting sensitive drugs for treatment can effective treatment be achieved. These resistance mutations are closely related to the efficacy of antiviral therapy and virus transmission. This study provides an important basis for the formulation of effective antiviral treatment and prevention and control strategies.