Analysis Of HIV-1Drug-resistant Genetic Epidemiology Characteristics Of Yunnan Province In2011

Objective:Through research, understand HIV-1strain of HIV patients inyunnan province resistant genotypes and the region and the distribution of thepopulation; HIV-1strain of drug resistance gene subtype in yunnan province formolecular epidemiological studies, clear HIV-1strains pop and variation of yunnanprovince; Build effective HIV/AIDS prevention and control measures for theadministrative department of public health and formulate reasonable antiviraltreatment and curative effect evaluation scheme to provide powerful basis, so as tocontrol the infection and spread of HIV.Methods:Analysis of Yunnan province from2011to AIDS antiviral treatment morethan six months, viral load>1000copies/mL of patients screened, collection andseparation of whole blood plasma for Bayer VERSANTTM440Molecular Systemdetermination of viral load, at the same time, collecting the epidemiologicalinformation of patients, and analyzed demographic and epidemiologicalcharacteristics of the United States ABI9700PCR amplification ReverseTranscription Polymerase Chain Reaction set type (Reverse Transcription-Polymerase Chain Reaction, RT-PCR) amplification, amplification products sent tothe Beijing bo, sequencing, the sequencing results submitted to Stanford universityHIV resistant analyze drug resistance mutation database (http://hivdb.stanford.edu).The resulting sequence according to the United States Los Alamos national laboratoryHIV nucleic acid sequences in the library provide BLAST classification analysis toolsfor gene subtype classification analysis.Results:624cases of patients with positive sample amplification, gene resistance testresults show that the resistance of280people.In the280series, protease inhibitors(protease inhibitors, PIs) the incidence of drug resistance was4.64%(13/280).Nucleotide (acid), reverse transcriptase inhibitors (nucleoside analogue reverse transcriptase inhibitors, NRTIs) the incidence of drug resistance was59.29%(166/280), mainly3TC and the FTC. The nuclear nucleoside reverse transcriptaseinhibitors (non-nucleoside analogue reverse transcriptase inhibitors, NNRTIs) theincidence of drug resistance was88.93%(249/280), mainly NVP and EFV. Highresistance mutation for M184V, D67N, K70R, K103N, Y181C and G190A.Confirmed280cases of drug resistance gene subtype,127cases (45.36%)respectively for CRF08_BC subtypes,56cases (20.0%) as CRF01_AE subtypes,27cases (9.64%) as CRF07_BC subtypes,27cases (9.64%) as the BC subtype,8cases(2.86%) as B subtype,19cases (6.79%) as the subtype C,16cases (5.71%) unknownrestructuring subtypes.Conclusion:1. The viral load> copies of the1000patients,23.37%(280/1198) of theantiviral treatment in patients with drug resistance. One NRTIs drugs（166/280）, theprevalence of resistance less than the resistance of NNRTIs drugs （249/280）. CauseNRTIs resistant mutation of the highest resistant mutation for M184V (143cases,40.39%), NNRTIs resistance variation caused by the highest resistant mutation forK103N (97cases,23.20%). As the extension of antiviral treatment time,drug-resistant HIV-1will also accumulate relevant mutations, as a result, theoccurrence of drug resistance is a major cause of HARRT treatment failure, thissuggests we should timely detection of drug resistance, prevent the emergence ofmulti-drug resistance and cross resistance.2. Now the antiviral treatment of a line or two main NRTIs and a NNRTIscombination, the results of this study show a181,181,190for NNRTI locus mutationrate is higher. So for NNRTIs drug resistance mutations of attention and concernshould become our country in the process of HAART a very serious problem.3. Resistance to detect HIV-1help science and the choice of treatment plan, whileimprove the effect of HARRT, drug resistance testing on a regular basis, caneffectively save the lack of drug resources, reduce the epidemic spread ofdrug-resistant strains.4. Epidemic strains of HIV-1complex in yunnan province, the different patient’sbody is most suitable for HIV-1species is different. And has significant regional characteristic, should be closely monitored.5. CRF08_BC is still the main popular subtypes.