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目的对河南省既往献血员抗病毒治疗后HIV-1耐药毒株流行情况及影响因素进行研究。方法对河南部分地区2003～2009年接受抗病毒治疗的既往献血员进行横断面调查访谈和血样采集,实时荧光定量聚合酶链式反应(PCR)方法测定病毒载量和In-House方法进行基因型耐药性分析。结果在616例调查对象中,33.1%(204/616)调查对象检出基因型耐药。多因素Logistic回归分析显示,依从性差(OR=1.83,95%CI1.15～2.93,P=0.0112)、治疗时间(OR=1.73,95%CI1.12～2.66,P=0.0134)和初始治疗方案(OR=2.60,95%CI1.73～3.93,P﹤0.0001)是河南省耐药毒株流行的主要影响因素。结论河南省既往献血员人群中耐药毒株流行率较高并具有随治疗时间升高趋势,建议加强依从性管理,选用适合的初始抗病毒治疗方案,以减少耐药毒株的流行。
Objective To study the prevalence and influencing factors of HIV-1 drug-resistant strains after previous blood-donor antiviral treatment in Henan Province. Methods A cross-sectional interviews and blood samples were collected from previous blood donors who received antiretroviral therapy in some areas of Henan Province in 2003-2009. The viral load and In-House method were used for genotyping by real-time fluorescence quantitative polymerase chain reaction (PCR) Drug resistance analysis. Results Of the 616 subjects, 33.1% (204/616) of the respondents were genotype-resistant. Multivariate Logistic regression analysis showed that the treatment group had poor compliance (OR = 1.83, 95% CI 1.15-2.93, P = 0.0112), treatment time (OR = 1.73, 95% CI 1.12-2.66, P = 0.0134) (OR = 2.60, 95% CI 1.73 ~ 3.93, P <0.0001) were the main influencing factors of the epidemic of drug-resistant strains in Henan Province. Conclusions The prevalence of drug-resistant strains in blood donors in Henan Province is relatively high and tends to increase with the treatment time. It is suggested to strengthen the compliance management and select the appropriate initial antiviral treatment to reduce the prevalence of drug-resistant strains.