广州市外籍HIV-1抗体阳性者的基因型耐药分析

目的了解广州市外籍人类免疫缺陷病毒Ⅰ型（HIV-1）抗体阳性者中,耐药毒株的流行情况。方法应用巢式聚合酶链反应（PCR）方法,从广州市2008-2010年新确证的外籍HIV-1抗体阳性样本中,扩增蛋白酶（PR）和反转录酶（RT）基因序列,并与斯坦福耐药数据库比对,辨别耐药突变位点,分析耐药性。结果共获得90例外籍HIV-1抗体阳性者的PR和RT序列,耐药率为23.33%（21/90）,其中对蛋白酶抑制剂（PIs）耐药率为15.56%（14/90）,且集中表现为对NFV/r耐药,对核苷类反转录酶抑制剂（NRTIs）耐药率为6.67%（6/90）,对非核苷类反转录酶抑制剂（NNRTIs）耐药率为5.56%（5/90）;发现1例对除DRV/r外的所有其他PIs耐药,4例对所有NNRTIs耐药,2例对所有NRTIs耐药;发生频率较高的突变是L10I/V和K20I。结论广州市外籍HIV-1抗体阳性病例中存在耐药株的流行,尤其是耐多药毒株的存在,增加了广州市耐药毒株传播的风险。

Genotypic drug-resistance analysis of HIV-1 positive foreigners in Guangzhou

Objective To understand the prevalence of drug-resistance strains among the HIV-1positive foreigners in Guangzhou.Methods The PR and RT gene sequences of HIV-1were amplified by nested PCR.The drug resistant mutations were identified and the resistance to each drug was analyzed with Stanford University HIV Drug Resistance Database.Results A total of 90 cases of newly confirmed HIV-1positive foreigners from 2008 to 2010in Guangzhou were analyzed.The prevalence of resistance to any drug was 23.33%（21/90）in 90 sequences,in which the prevalence of resistance to PIs,NRTIs,NNRTIs were 15.56%（14/90）,6.67%（6/90）and 5.56%（5/90）,respectively.It was detected that one case of resistance to all PIs except DRV/r,four cases of resistance to all NNRTIs,two cases of resistance to all NRTIs,and high frequencies of L10I/V and K20 I.Conclusion The presence of drug-resistant,especially multi-drug-resistant strains in foreigners infected with HIV-1will increase risk of the spread of drug-resistant strains in Guangzhou