中国麻风皮肤病杂志 ›› 2025, Vol. 41 ›› Issue (9): 648-653.doi: 10.12144/zgmfskin202509648

• 论著 • 上一篇    下一篇

南京市95例HIV-1感染者ART后耐药变化分析

王雯菁,徐亮,乔润洁,孙梅,吴旭平   

  1. 南京中医药大学附属南京医院(南京市第二医院)精准医学中心，江苏南京，210003
  • 出版日期:2025-09-15 发布日期:2025-09-08

Analysis of drug resistance changes after ART in 95 HIV-1 patients in Nanjing City

WANG Wenjing, XU Liang, QIAO Runjie, SUN Mei, WU Xuping   

  1. Precision Clinical Laboratory, The Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing 210003, China
  • Online:2025-09-15 Published:2025-09-08

PDF (PC)

13

摘要： 目的：分析HIV-1感染者抗逆转录病毒治疗后的耐药情况，为改善患者的治疗效果提供依据。方法：收集我院2021年1月至2024年4月95例HIV-1感染者的人口学信息，采集患者用药前后的血液，检测T淋巴细胞计数，HIV RNA载量及基因型耐药性，分析南京市HIV-1感染者的耐药情况。结果：95例患者中，新发患者61例，经治患者34例。共采集样本190份，包括CRF01_AE型91份、B/C重组亚型46份、B型24份、CRF07_BC型7份、A1型7份、CRF55_01B型5份及其他型别10份。CRF01_AE型及CRF55_01B型的CD4+T淋巴细胞、CD4+/CD8+比值低于其他型别(P＜0.05)；A1型基因突变频率较高，B/C重组型的突变频率较低。32.79%新发患者反转录区K65、M184、V106位点的突变率明显增加，核苷类和非核苷类药物的药物压力明显增加(P＜0.05)。所有患者的T淋巴细胞计数在短期内没有明显改变(P＞0.05)。结论：新发HIV-1感染者治疗后的耐药率明显增加，其在ART前应检测患者基线耐药，选择合适的药物以降低患者的病毒载量、减少耐药频率的发生。

关键词: HIV-1 RNA, 耐药性, T淋巴细胞计数

Abstract: Objective: To analyze the drug resistance status of HIV-1 infected patients after antiretroviral therapy and provide a basis for improving the treatment effect of patients. Methods: The demographic information of 95 HIV-1 infected patients in our hospital from January 2021 to April 2024 was collected. Blood samples were collected from the patients before and after medication, and the T lymphocyte count, HIV RNA load and genotypic drug resistance were detected to analyze the drug resistance status of HIV-1 infected patients in Nanjing. Results: Among the 95 patients, there were 61 newly diagnosed patients and 34 previously treated patients. A total of 190 samples were collected, including 91 of CRF01_AE type, 46 of B/C recombinant subtype, 24 of B type, 7 of CRF07_BC type, 7 of A1 type, 5 of CRF55_01B type and 10 of other types. The CD4+ T lymphocyte count and CD4+/CD8+ ratio of CRF01_AE type and CRF55_01B type were lower than those of other types (P＜0.05); the gene mutation frequency of A1 type was relatively high, while that of B/C recombinant type was relatively low. The mutation rates of K65, M184 and V106 sites in the reverse transcription region increased significantly in 32.79% newly diagnosed patients, and the drug pressure of nucleoside and non-nucleoside drugs increased significantly (P＜0.05). There was no significant change in the T lymphocyte count of all patients in the short term (P＞0.05). Conclusion: The drug resistance rate of newly diagnosed HIV-1 infected patients after treatment increases significantly. Baseline drug resistance should be detected before ART, and appropriate drugs should be selected to reduce the viral load of patients and the occurrence frequency of drug resistance.

Key words: HIV-1 RNA, drug resistance, T lymphocyte count