Drug resistance and its influencing factors in AIDS patients receiving HAART in Harbin
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摘要: 目的 了解哈尔滨市抗病毒治疗的艾滋病患者耐药情况,并探讨其相关影响因素。方法 选择2015年哈尔滨市正在接受治疗的艾滋病(acquired immunodeficiency syndrome,AIDS)患者进行回顾性流行病学调查及对采集的血样通过基因型耐药分析法对其进行耐药检测及分析。结果 被纳入研究的269名研究对象经检测分析人群总耐药率为26.8%。人类免疫缺陷病毒-1(human immunodeficiency virus,HIV-1)毒株对逆转录酶类抑制剂的耐药程度高于蛋白酶类抑制剂(χ2=13.430,P<0.001)。对患者不同特征与耐药的发生进行单因素Logistic分析的结果表明患者的初始治疗方案及治疗时间对耐药的影响均有统计学意义(均有P<0.05);性别、年龄、感染途径、CD4+T淋巴细胞数对耐药性的影响均没有统计学意义(均有P>0.05)。多因素Logistic回归分析表明,患者的治疗时间、初始CD4+T淋巴细胞数及初始治疗方案与艾滋病毒株耐药变异的发生具有相关性。结论 哈尔滨市接受抗病毒治疗的AIDS患者耐药率处于较高水平,应加强对抗病毒治疗时间较长,身体免疫状况较差的患者的随访,同时加强对相关治疗方案的监测,以降低耐药的发生,减少患者的死亡。
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关键词:
- 获得性免疫缺陷综合征 /
- 病毒 /
- 耐药性
Abstract: Objective To investigate the prevalence of HIV-1 drug resistance and related factors in AIDS patients receiving antiretroviral therapy in Harbin. Methods AIDS patients receiving treatment in Harbin in 2015 were chosen for a retrospective study and blood sample collection. The mutation of HIV drug resistance was determined through sequencing pol gene of HIV-1. Results A total of 269 subjects were included in the analysis.The total drug resistance rate was 26.8%.Resistant rate to NRTIs and NNRTIs was higher than that to PIs(χ2=13.430,P<0.001).The single factor analysis found that the influence of initial treatment and treatment time on drug resistance was statistically significant (all P<0.05).There was no statistical significance on the influence of sex,age,transmission route,CD4+T lymphocyte count on drug resistance (all P>0.05).As shown by Logistic regression analysis,the relationship of drug resistance with treatment time,the level of CD4 cells and initial treatment had statistical significance. Conclusions The prevalence of HIV-1 drug resistance in AIDS patients receiving antiretroviral therapy was high in Harbin.It is suggested that the patients who were with long treatment regimes should be intensified, so as to reduce the occurrence of drug resistance and the death of AIDS.-
Key words:
- Acquired immunodeficiency syndrome /
- Viruses /
- Drug resistance
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