初治使用含克立芝方案出现病毒学失败HIV/AIDS患者耐药情况分析

目的 分析初次使用含克立芝抗病毒治疗方案治疗艾滋病病毒感染者/艾滋病病人治疗失败基因型耐药情况。方法 收集云南省2014-2015年接受高效抗逆转录病毒治疗的艾滋病病毒感染者/艾滋病病人的临床及实验室资料,对初次使用含克立芝抗病毒治疗方案治疗且治疗持续6个月以上、病毒载量仍大于1 000Copies/ml的患者进行基因型耐药检测,分析耐药基因变异情况及耐药位点的变化情况。结果 2年共获得符合条件pol区序列150条,该人群中耐药发生率为27.3%(41/150)。在使用过的药物中,对3TC、TDF、D4T、AZT、ABC高度耐药的情况分别是16(10.7%)、2(1.3%)、1(0.7%)、0(0%)、3(2.0%),对蛋白酶抑制剂没有出现高度耐药的情况。结论 初治使用含克立芝治疗方案治疗失败的病人耐药率仍处于较低水平,但是随着使用含克立芝方案治疗人数增加以及治疗时间延长,仍需加强耐药检测。

Drug resistance of initial antiviral therapy including LPV/r failed for HIV/AIDS patients

Objective To analyze the genotypic drug resistance of the initial antiviral therapy including LPV/r failed for HIV/AIDS patients. Methods We collected the latest clinical and laboratory data of HIV/AIDS patients who failed in the LPV/r treatment at least 6 months and analyzed the drug resistance gene mutation from 2014 to 2015 in Yunnan Province. Results A total of 150 pol sequences were obtained in 2 years and the drug resistance rate in the population was 27.3% (41/150).Among the drug-use period,the rates of high resistance to 3TC,TDF,D4T,AZT and ABC were 16 (10.7%),2 (1.3%),1 (0.7%),0 (0%),3 2.0%),without highly resistantance to protease inhibitors. Conclusion Drug-resistant rates in patients who had failed treatment with LPV/r are still at a low level,but drug resistance testing is still to be enhanced with the use of LPV/r-containing regimen increased and the treatment time extended.