~(60)钴辐照法对生物羊膜中人类免疫缺陷病毒灭活效果的研究

目的研究60钴辐照法对生物羊膜中污染的人免疫缺陷病毒灭活效果。方法采用细胞培养法,对辐照法灭活生物羊膜中人工污染HIV-1ⅢB病毒效果进行观察。结果经辐照剂量为25 k Gy处理,可使污染在生物羊膜制品的HIV-1ⅢB病毒滴度下降6.5个log以上。处理后生物羊膜制品经细胞培养盲传三代,均未出现细胞病变。结论 25 k Gy辐照法能够完全灭活生物羊膜产品中污染的人免疫缺陷病毒。     

静脉注射人免疫球蛋白酸性孵放法灭活艾滋病病毒的效果研究

目的研究静脉注射人免疫球蛋白在生产过程中酸性孵放法灭活艾滋病病毒的效果。方法采用细胞培养法,对含有艾滋病病毒的静脉注射人免疫球蛋酸性孵化法灭活效果进行了实验室检测。结果将含有艾滋病病毒的静脉注射人免疫球蛋白酸度调整为pH4,于21～25℃条件下放置4d,其中艾滋病病毒的滴度(TCID50)由9.50log下降至2.00log以下,下降值达到7.00log以上。相同的样品在pH值7.0条件下放置14d,其中艾滋病病毒滴度仍在3.3log以上;经放置21d,所有样品中艾滋病病毒滴度均在2.0log以下。经过对3批样品重复测定,均未出现细胞病变;经过将样品盲传三代仍未出现细胞病变。结论采用酸性孵放法常温下放置21d,可使静脉注射人免疫球蛋白中艾滋病病毒完全失去活性。     

两种非核苷类逆转录酶抑制剂与已上市药物联合应用的体外抗HIV活性研究

目的：评价两种非核苷类逆转录酶抑制剂（JB25、JB26）与3种已上市药物齐多夫定（AZT）、依非韦仑（EFV）、沙奎那韦（SQV）联合应用的体外抗HIV活性。方法：将10个浓度的JB25、JB26分别与AZT、EFV、SQV的7个浓度组成各种浓度的组合,加入384孔细胞培养板,与HIV-1ⅢB急性感染的MT-2细胞共培养3d,最后利用TZMbl细胞报告基因检测HIV-1的表达,共重复3次。利用MacSynergyⅡ软件对数据进行分析,得到药物相互作用的情况。结果：JB25与AZT、EFV、SQV的平均协同/拮抗容量分别是244.45/-5.05,119.58/-65.93,145.83/-0.32（nmol/L）2%;JB26与AZT、EFV、SQV的平均协同/拮抗容量分别是398.90/0,103.62/-0.49,138.473/-0.27（nmol/L）2%。结论：两种非核苷类逆转录酶抑制剂与3种已上市的药物在体外联合应用,具有协同抗HIV作用,MacSynergyⅡ软件可以全面评价两种药物的联合作用情况。     

ASPCR检测微量HIV-1 K103N耐药突变方法的建立

目的 建立检测微量HIV-1 K103N耐药突变的等位基因特异扩增实时定量PCR(allele-specific real-time PCR,ASPCR)方法,用于微量K103N耐药突变的检测和分析.方法 首先建立检测K103N耐药突变的ASPCR方法,然后对方法进行验证,最后采用ASPCR方法检测对照样本.构建含K103N突变的质粒作为标准品,然后设计特异性引物用以区分野生型和突变型模板,采用SYBR green法进行实时定量PCR,并绘制标准曲线.分别采用特异性和非特异性引物扩增模板,根据二者Ct(cycle threshold)值结合相应的标准曲线判断是否存在K103N突变及突变比例.对ASPCR检测K103N突变位点的特异性、敏感性、准确性、重复性等进行验证.结果 特异性和非特异性引物扩增等量野生型模板的Ct值之差(△Ct)可达13.56;当突变比例小于0.1%时仍具有良好的准确性;批内变异系数小于0.7,批间变异系数小于1.6;检测灵敏度可达0.01%.检测阴性对照样本的△Ct显著高于临界值,阳性对照样本检测结果均为刚性.结论 ASPCR是一种快速、灵敏、准确的检测HIV-1微量耐药突变的方法,可为临床抗病毒治疗提供理论指导.     

WuT系列试剂检测我国不同地区艾滋病病人CD4和CD8细胞相对计数的效果评价

目的评价武汉生物制品研究所WuT系列CD3FITC/CD4PE和CD3FITC/CD8PE试剂,检测我国不同地区的艾滋病病毒(HIV)感染者/艾滋病(AIDS)病人CD4和CD8细胞相对计数的效果。方法以美国BD公司的试剂为参比,用CD3FITC/CD4PE和CD3FITC/CD8PE试剂分别检测616人的CD4/CD3比值和584人的CD8/CD3的比值,用线性回归方法对结果进行比较。结果CD3FITC/CD4PE和CD3FITC/CD8PE试剂与参比试剂的检测结果有较好的一致性。CD3FITC/CD4PE试剂与参比试剂的检测结果呈正相关关系(r=0.956,P<0.01),回归方程为y=0.922x 0.0047;CD3FITC/CD8PE试剂与参比试剂的检测结果也呈正相关关系(r=0.941,P<0.01),回归方程为y=0.9464x 0.0097。结论WuT系列CD3FITC/CD4PE和CD3FITC/CD8PE试剂检测我国不同地区艾滋病病人的CD4和CD8细胞的相对计数取得较好的效果。     

对in-house HIV-1基因型耐药性检测方法的评价

目的 评价in-house HIV-1基因型耐药检测方法的敏感性与准确性。方法 收集2004年4月至2008年10月全军艾滋病检测中心检测的来自河南、广西130份血浆标本。以美国FDA批准的HIV-1基因型耐药性检测系统(ViroSeqTM v2.0)为参考方法,并与建立起的基因型耐药性检测方法(in-house)平行检测待检样本,比较二者在扩增效率、耐药突变位点检测以及耐药报告等方面的一致性。结果已知的14 850个耐药突变位点中,2种方法可同时对99.3％(14 752/14 850)的耐药突变位点准确检出;在对不同突变位点的检测中,2种方法对蛋白酶抑制剂耐药突变位点、逆转录酶抑制剂耐药突变位点及两类抑制剂耐药突变位点检测一致率分别为99.7％、99.0％和99.3％（Kappa值分别为0.909 9、0.952 1和0.948 8,P值均＜0.01）;2种方法出具的两类药物的耐药结果报告一致率94.6％（Kappa=0.637 4,P＜0.01）。本研究共检测到34个ViroSeqTM数据库(ViroSeqTM software v2.7)未收录位点,其中2个突变位点对耐药的影响较大。结论in-house基因型耐药性检测方法与ViroSeqTM基因型耐药性检测系统在耐药突变位点检测以及评价上具有高度一致性,是一种快速准确、性价比高的HIV-1基因型耐药检测方法,同时在耐药数据库方面具有一定优势。     

河南某农村接受抗病毒治疗的艾滋病患者HIV-1耐药发生的六年队列分析

Objective To analyze the occurring rules of human immunodeficiency virus (HIV)drug resistance under an unique therapy model among HIV-1 infected individuals on antiretroviral therapy (ART) in rural areas of Henan, China. Methods A cohort of 75 individuals on an ART regimen of zidovudine (ZDV) , dideoxyinosine (ddI) and nevirapine (NVP) was established in March 2003. A total of 12 surveillances were conducted and 788 person-times were studied until 2010. The parameters of CD4 cell count and viral load (VL) were tested in each survey. And genotypic resistance testing was performed in patients with a failure of viral suppression. Survival analysis was used to estimate the occurrence time of resistance. Results The cumulative mortality rate was 16% (12/75) in the cohort. And the cumulative resistance rate was 88% (66/75) from 2004 to 2010. The rate of resistance reached 54. 7% and the probability from susceptibility to drugs developing resistance decreased drastically from 100% to 45. 3% within the first 1 year of initiation. The occurrence time of resistance for half of individuals in the cohort was at 12.0 months(95% CI 8. 6 - 17. 0)after initiation, 25. 1 months(95%C/19.0-33. 3)in those whose VL was less than 4. 0 lgU/ml and 4. 8 months (95% CI 4.1 - 5. 6) at VL ＞ 4. 0 lgU/ml during the first investigation. The individuals with an early occurrence of resistance within 12 months carried high risks for afailure of viral suppression and a decrease of CD4 counts. Conclusion The occurrence of resistance rises with the course of therapy. And the greatest probability for resistance is within the first 1 year of initial therapy. A high level of VL has a significant impact on the development of resistance. Preventing the occurrence of resistance during the initial therapy remains a key goal.     

吗啡对拉米夫定抗HIV-1药效影响的体外MT2细胞实验研究

目的 探讨吗啡是否影响拉米夫定(3TC)抗HIV-1的抗病毒效果.方法 MT2细胞随机分为吗啡+3TC、吗啡+纳洛酮+3TC、纳洛酮+3TC处理组及3TC对照组和病毒对照组;用纳洛酮处理相应组的MT2细胞0.5 h后,加入吗啡处理细胞24 h,然后每组细胞加入等量的HIV-1ⅢB病毒和3TC溶液;病毒感染细胞第3、4、5和6天,取培养上清,用ELISA法检测培养上清的HIV-1 p24抗原,根据p24抗原表达量,计算各个处理组的3TC抗HIV-1 p24抗原抑制率.结果 HIV-1感染细胞第3和第4天,吗啡+3TC处理组的3TC抗HIV-1 p24抗原抑制率最低,与3TC对照组相比差异有统计学意义(P<0.05);吗啡+纳洛酮+3TC处理组和纳洛酮+3TC处理组的3TC抗HIV-1 p24抗原抑制率相当,两组差异无统计学意义(P>0.05),这两组分别与3TC对照组相比,差异无统计学意义(P>0.05);病毒感染细胞第5和第6天,各处理组的3TC抗HIV-1 p24抗原抑制率与3TC对照组相比,差异无统计学意义(P>0.05);各个处理组的3TC抗HIV-1 p24抗原抑制率随感染时间延长而降低,呈现时间一效应关系.结论 吗啡在病毒感染初期能降低3TC 的抗HIV-1药效;纳洛酮能够阻滞吗啡降低3TC的抗HIV-1药效作用.

Abstract：

Objective To determine whether morphine having the ability to influence the antiviral effect of lamivudine(3TC)in vitro study.Methods MT2 cells were randomly assigned into morphine+3TC treatment group,morphine+naloxone+3TC treatment group,naloxone+3TC treatment group.Both 3TC and virus control groups were set up.The corresponding MT2 cells were treated with opiates antagonist(naloxone)for 0.5 hours before the 24-hours morphine treatment program was implemented while all of the groups were then infected with equal amounts of cell-free HIV-1 ⅢB strain and 3TC.HIV-1 p24 antigen in culture supernatants collected at days 3,4,5 and 6after infection status was tested and the inhibition of 3TC anti-HIV-1 p24 antigen of various treatment groups calculated.Results Inhibition of 3TC anti-HIV-1 p24 antigen of Morphine+3TC treatment group was the lowest when HIV-1 infected cells at 3rd and 4th day and showed significant difierence (P<0.05)when compared to the 3TC control.However,there was no statistically significant difference among them(P>0.05),when virus was infected the cells at 5th and 6th day.The difference of 3TC anti-HIV-1 p24 antigen inhibition between the morphine+naloxone+3TC treatment group and the naloxone+3TC treatment group was not significant(P>0.05).Similar results were obtained when these two groups were compared to the 3TC control group(P>0.05),respectively.The 3TC anti-HIV-1 p24 antigen inhibition of each treatment group reduced as the time of infection prolonged,showing a significant and time-course effbct.Conclusion The 3TC antiviral effect was reduced by morphine in the early stage of infection,and could be blocked by naloxone.     

河南某农村接受抗病毒治疗的艾滋病患者HIV-1耐药发生的六年队列分析

Objective To analyze the occurring rules of human immunodeficiency virus (HIV)drug resistance under an unique therapy model among HIV-1 infected individuals on antiretroviral therapy (ART) in rural areas of Henan, China. Methods A cohort of 75 individuals on an ART regimen of zidovudine (ZDV) , dideoxyinosine (ddI) and nevirapine (NVP) was established in March 2003. A total of 12 surveillances were conducted and 788 person-times were studied until 2010. The parameters of CD4 cell count and viral load (VL) were tested in each survey. And genotypic resistance testing was performed in patients with a failure of viral suppression. Survival analysis was used to estimate the occurrence time of resistance. Results The cumulative mortality rate was 16% (12/75) in the cohort. And the cumulative resistance rate was 88% (66/75) from 2004 to 2010. The rate of resistance reached 54. 7% and the probability from susceptibility to drugs developing resistance decreased drastically from 100% to 45. 3% within the first 1 year of initiation. The occurrence time of resistance for half of individuals in the cohort was at 12.0 months(95% CI 8. 6 - 17. 0)after initiation, 25. 1 months(95%C/19.0-33. 3)in those whose VL was less than 4. 0 lgU/ml and 4. 8 months (95% CI 4.1 - 5. 6) at VL ＞ 4. 0 lgU/ml during the first investigation. The individuals with an early occurrence of resistance within 12 months carried high risks for afailure of viral suppression and a decrease of CD4 counts. Conclusion The occurrence of resistance rises with the course of therapy. And the greatest probability for resistance is within the first 1 year of initial therapy. A high level of VL has a significant impact on the development of resistance. Preventing the occurrence of resistance during the initial therapy remains a key goal.     

用M13噬菌体PⅢ蛋白Ⅰ-Ⅱ结构域表达HIV-1 gp41抗原表位

目的:探讨M13噬菌体PⅢ蛋白Ⅰ-Ⅱ结构域表达融合蛋白的可行性。方法:以纯化的HIV-1感染者血清多克隆抗体为配体,在噬菌体展示随机十二肽库中进行生物淘洗,经ELISA鉴定阳性克隆,DNA测序,确定优势表位。将优势表位及两个优势表位的串联体分别与M13噬菌体PⅢ蛋白Ⅰ-Ⅱ结构域连接,克隆入PQE30载体进行蛋白表达,再以表达蛋白为抗原检测HIV-1感染者血清中的抗体。结果:成功筛选到位于HIV-1 gp41蛋白上的3组优势抗原表位(HGPKDAETTAIW;AAFKDNQLLRIW;AAFKDNQLTRIW),3组优势表位及表位串联体(YGPKDAETTAIW-GGGS-SCSAKFTCTTQI)在PQE30载体中实现可溶性融合表达。重组蛋白具有良好的抗原性,能与不同的HIV-1抗体阳性血清呈特异反应。结论:用M13噬菌体PⅢ蛋白Ⅰ-Ⅱ结构域表达HIV-1 gp41抗原表位是可行的。