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目的研究我省男男性行为者(MSM)中未经抗病毒治疗的人类免疫缺陷病毒(HIV)感染者的原发性基因耐药性突变发生情况,为该人群的抗病毒治疗药物选择提供依据。方法采集福建省尚未接受抗病毒治疗的MSM HIV-1感染者的外周静脉抗凝全血,分离血浆,提取血浆中HIV RNA,用RT-PCR方法扩增HIV pol区蛋白酶基因全序列与部分逆转录酶序列。所得扩增片段进行序列测定后,数据运用Contig Express拼接编辑校正后上传至斯坦福大学HIV耐药数据库进行比对,同时运用Bio-Edit和Mega等软件进行系统发生分析。结果获得50份HIV-1分离株完整的PR和RT基因序列,其中60%(30/50)为01_AE重组亚型,18%(9/50)为B亚型,20%(10/50)为07_BC重组亚型,1例08_BC重组亚型。耐药分析显示,1例发生PI(蛋白酶抑制剂)药物的主要耐药突变M46I,造成对NFV中度耐药。10例样本出现NNRTIs和NRTIS的耐药相关突变,仅1例解释为对NNRTIs的潜在低水平耐药,由V179E引起。结论福建省MSM HIV-1感染者的原发性耐药突变发生率低,有利于今后该人群抗病毒治疗工作的开展,但需加强监控该人群耐药毒株的传播。
Objective To study the occurrence of primary genetic resistance mutations in HIV-negative patients without MSV in MSM in our province, and to provide a basis for the selection of antiviral drugs in this population . Methods Peripheral anticoagulated whole blood was collected from MSM HIV-1 infected patients who had not received antiviral therapy in Fujian Province. Plasma was extracted and HIV RNA was extracted from the plasma. RT-PCR was used to amplify the complete sequence of the protease gene in HIV pol region and partial reverse Recipe sequence. The obtained amplified fragments were sequenced. The data were compiled and edited by Contig Express, then uploaded to Stanford University HIV-resistant database for comparison, and phylogenetic analysis was performed by using software such as Bio-Edit and Mega. Results The complete PR and RT gene sequences of 50 HIV-1 isolates were obtained, of which 60% (30/50) were 01_AE recombinant subtype, 18% (9/50) were subtype B, 20% (10/50) 07_BC recombinant subtype, 1 case 08_BC recombinant subtype. Resistance analysis showed that one of the major drug-resistant mutants M46I that developed a PI (protease inhibitor) drug resulted in moderate resistance to NFV. In 10 samples, resistance-related mutations in NNRTIs and NRTIS occurred, and only 1 case was interpreted as potential low-level resistance to NNRTIs, caused by V179E. Conclusions The low incidence of primary drug-resistant mutations in HIV-1-infected MSM patients in Fujian Province is conducive to the future antiretroviral treatment in this population. However, it is necessary to monitor the spread of drug-resistant strains in this population.