基于流行病学的结核病/艾滋病双重感染特征及相关基因耐药机制分析

Jingjing Yang, Xiaoyan Zheng, Shuai Zhang, Hanwei Wang
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引用次数: 1

摘要

本研究旨在探讨结核病(TB)和人类免疫缺陷病毒(HIV)/获得性免疫缺陷综合征(AIDS)双重感染人群的人群特征及耐药基因突变,为TB/HIV双重感染的临床筛查和预防提供参考。选取福州市疾病预防控制中心登记的结核病患者和艾滋病毒感染者/艾滋病患者作为研究对象。讨论了结核/艾滋病双重感染人群特征及耐药基因突变。结果发现,20 ~ 40岁结核病患者HIV感染率最高,40岁以上人群次之。涂片阴性结核患者的HIV感染率高于涂片阳性结核患者。20-40岁的HIV/AIDS患者结核病感染率最高。此外,男性的艾滋病毒感染率高于女性,已婚人士的艾滋病毒感染率低于单身人士。结核分枝杆菌(MTB)对异烟肼的耐药率最高(42.86%),其次是氧氟沙星(34.82%)、链霉素(33.81%)和利福平(32.15%)。113例多重耐药菌株中,rpoB基因突变82例,基因突变率为55.75%。突变范围从密码子511到密码子569。共有31例发生katG/inhA基因突变。其中,katG单基因突变17例,inhA单基因突变9例,katG与inhA基因联合突变5例。建议对40岁以上、涂片阴性、男性、单身、20 ~ 40岁艾滋病毒感染者/艾滋病患者开展重点结核病/艾滋病双向筛查。该地区结核分枝杆菌对抗结核药物的耐药性普遍较高,且复发患者的耐药性明显高于新治疗患者。抗性基因中,rpoB基因突变频率最高,其次是katG基因和inhA基因。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Epidemiology-based Analysis of Characteristics of Dual Infection of Tuberculosis /Acquired Immune Deficiency Syndrome (AIDS) and Drug Resistance Mechanism of Related Genes.

This research was to explore the population characteristics and drug-resistant gene mutations of tuberculosis (TB) and human immunodeficiency virus (HIV)/acquired immune deficiency syndrome (AIDS) dual infection population, and to provide a reference for clinical screening and prevention of TB/HIV dual infection. TB patients and HIV-infected/AIDS patients registered in Fuzhou Center for Disease Control and Prevention were selected as research subjects. The population characteristics of TB/HIV dual infection and mutation of drug-resistant genes were discussed. It was found that TB patients aged 20-40 years had the highest HIV infection rate, followed by those aged over 40 years. The rate of HIV infection in smear-negative TB patients was higher than that in smear-positive TB patients. HIV/AIDS patients aged 20-40 had the highest TB infection rate. In addition, men had higher rates of HIV than women, and married people had lower rates of HIV than single people. Mycobacterium tuberculosis (MTB) had the highest resistance to isoniazid (42.86%), followed by ofloxacin (34.82%), streptomycin (33.81%), and rifampicin (32.15%). Among the 113 cases of multi-drug resistant strains, 82 cases had mutations in the rpoB gene, with a gene mutation rate of 55.75%. The mutations ranged from codon 511 to codon 569. A total of 31 cases had mutations in the katG/inhA gene. Of which, there were 17 cases of katG single gene mutation, 9 cases of inhA single gene mutation, and 5 cases of combined katG and inhA gene mutation. It was suggested that it was necessary to carry out key TB/HIV two-way screening for TB patients older than 40 years old/smear-negative and male, single, and HIV-infected/AIDS patients aged 20-40. The resistance of MTB to antiTB drugs in this area was generally high, and the drug resistance of retreated patients was significantly higher than that of newly treated patients. Among the resistance genes, the rpoB gene had the highest mutation frequency, followed by the katG gene and inhA gene.

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