内科

目的了解广西边境城市崇左市新报告艾滋病病毒1型（HIV-1）感染者的基因亚型及治疗前耐药（PDR）情况，为评估现有一线疗法的长期效果和调整抗病毒治疗方案提供参考。方法选取2018年1～9月广西崇左市大新县、龙州县和宁明县新报告的HIV-1感染者149例为研究对象，检测分析其基因亚型和PDR情况；对影响感染者发生PDR的因素进行单因素Logistic回归分析。结果新报告HIV-1感染者的HIV基因亚型中CRF01_AE占87.9%，CRF08_BC和CRF07_BC分别占6.0%和4.7%；基因距离分析显示CRF01_AE＞CRF07_BC＞CRF08_BC；149例新报告HIV-1感染者中，发生PDR10例（6.7%），其中对非核苷类逆转录酶抑制剂（NNRTIs）耐药6例，其优势耐药位点为V106I；对核苷类逆转录酶抑制剂（NRTIs）和蛋白酶抑制剂（PIs）耐药各2例；未发现同时对2种及以上抗逆转录病毒（ARV）药物耐药的新报告HIV-1感染者。单因素Logistic回归分析结果显示，耐药与不耐药的新报告HIV-1感染者的性别、年龄、所在地、民族、文化程度、职业、危险因素等比较差异均无统计学意义（P＞0.05）。结论广西崇左市边境地区新报告的HIV-1感染者治疗前耐药发生情况已达到警戒线水平，加强耐药监测、及时调整优化抗病毒治疗方案，将有助防止耐药毒株的广泛传播、控制疫情。

ObjectiveTo understand gene subtype and pre-treatment drug resistance (PDR) of newly reported patients infected with human immunodeficiency virus 1 (HIV-1) in the border of Chongzuo in Guangxi, and to provide a reference for evaluating the long-term effects of existing first-line drugs, and for adjusting the antiviral treatment scheme. MethodsA total of 149 newly reported HIV-1 infected patients in Daxin County, Longzhou County and Ningming County of Chongzuo City from January to September 2018 were selected as the research objects, and their gene subtypes and PDR status were detected and analyzed. Univariate logistic regression analysis was performed on the factors affecting the occurrence of PDR among infected patients. ResultsFor gene subtypes in the newly reported HIV-1 infected patients, CRF01_AE accounted for 87.9%, CRF08_BC and CRF07_BC for 6.0% and 4.7%, respectively. The genetic distance analysis was expressed in descending order as follows: CRF01_AE > CRF07_BC > CRF08_BC. Among the 149 newly reported HIV-1 infected patients, PDR occurred in 10 cases (6.7%), of which 6 cases were resistant to non-nuclear reverse transcriptase inhibitors (NNRTIs), and the dominant drug resistance site was V106I; meanwhile, 2 cases were resistant to nucleoside reverse transcriptase inhibitors (NRTIs) and protease inhibitors (PIs), respectively. No newly reported HIV-1 infected patient who was resistant to two or more drugs of antiretrovirus (ARV) at the same time was observed. The univariate logistic regression analysis results showed that there was no statistically significant differences in gender, age, location, nationality, education level, occupation, and risk factors between drug-resistant and non-resistant newly reported HIV-1 infected patients (P＞0.05). ConclusionThe PDR among HIV-1 newly reported patients in the border area of Chongzuo, Guangxi has already reached alarm levels. Drug resistance monitoring and timely optimization of antiviral treatment schemes are helpful to prevent the widespread of drug-resistant strains, and to control the epidemic.