摘要/Abstract

摘要： 目的·探究基因1型丙型肝炎病毒（hepatitis C virus，HCV）/人类免疫缺陷病毒（human immunodeficiency virus，HIV）共同感染患者直接抗病毒药物（direct-acting antiviral agents，DAAs）预存耐药突变流行情况，以期对这一特殊群体的耐药情况有所了解。方法·通过美国国家生物技术信息中心（NCBI）核酸数据库进行数据挖掘，找出全部基因1型HCV/HIV共同感染患者的NS3和NS5B序列。然后用MEGA 5.0软件进行序列的比对和耐药分析。结果·总体来讲，无论基因1a型还是基因1b型，HCV/HIV共同感染患者NS3区的预存耐药突变流行率高（分别是26.06% 和38.18%）。在基因1a型患者中，高耐药相关突变主要出现在Q80上（8.45%）；而在基因1b型患者中，S122耐药突变最为常见（36.36%）。在NS5B区的预存耐药突变罕见（0.77%），尤其是在基因1a型患者中，没有1条序列检测到耐药相关突变。结论·基因1型HCV/HIV共同感染患者NS3区的预存耐药突变流行率高，但NS5B区的预存耐药突变罕见。对HCV/HIV共同感染这一特殊群体使用DAAs治疗时，以NS5B抑制剂为基础的联合方案是很有必要的。
关键词: 丙型肝炎病毒, 共同感染, 直接抗病毒药物, 耐药相关突变, 流行率
Abstract:
Objective · To investigate the prevalence of pre-existing direct-acting antiviral agents (DAAs) resistance associated variants (RAVs) in genotype 1 hepatitis C virus (HCV)/ human immunodeficiency virus (HIV) co-infected patients. Methods · All NS3 and NS5B HCV sequences in genotype 1 HCV/HIV co-infected patients were retrieved NCBI GenBank database. And sequences were aligned and analyzed using software MEGA 5.0. Results · In total, the overall prevalence of DAAs RAVs in NS3 region was high (26.06% and 38.18%, respectively), no matter in genotype 1a or genotype 1b. In genotype 1a, the high prevalence of RAVs mainly presented in the position Q80 (8.45%). In genotype 1b, S122 RAV was most observed(36.36%). It is worth noting that, RAVs in NS5B region were rare observed (0.77%) in this study, especially as no RAV was detected in any sequence of genotype 1a patients. Conclusion · The prevalence of pre-existing RAVs is high in NS3 region but rare in NS5B region in HCV/HIV co-infected patients, suggesting that NS5B inhibitors based combination regions are a better choice for HCV/HIV co-infected patients.
Key words: hepatitis C virus, co-infection, direct-acting antiviral agents, resistance associated variants, prevalence


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