Objective To understand the occurrence situation and characteristics of HIV-1 genetic drug resistance strains of HIV infection/AIDS patients with free antiviral treatment in Wenshan Prefecture of Yunnan Province during 2014-2015.Methods The clinical and laboratory data in 176 HIV/AIDS patients with free antiviral treatment in Wenshan Prefecture during 2012-2014 were collected.The patients with antiviral treatment for continuous more than 6 months and viral load still more than 1 000 copies/mL were performed the genetic drug resistance testing.Then the occurrence situation of drug-resistance and prevalence char-acteristics of drug resistance strains were analyzed.Results The virologic failure occurred in 176 AIDS patients during 2014-2015,176 case-times of genetic drug resistance were detected and 137 usable sequences were obtained.The occurrence rate of drug resistance in this population was 62.0%(85/137).In used drugs,62 cases (45.3%)and 50 cases(36.5%)were highly resistant to NVP and EFV;the highly resistance to 3TC,TDF,D4T and AZT had 31 cases (22.6%),12 cases(8.8%),8 cases (5.8%)and 2 cases (1 .5%)respectively,no case of highly resistant to PI occurred.There were 3 cases of drug resistance mutations related PI gene mutations,accounting for 2.2% (3/137);M46IM,T74S and L33I in each 1 case,respectively.Among the NRTI related muta-tions,the highest frequency of mutations was M184V/I,accounting for 23.4% (32/137).In the mutation with NNRTI,the highest frequency of mutations was K103N/S,which was 27% (34/137).Of all 137 complete gene sequences,67 cases (48.9%)were mainly the CRF08 BC subtype,followed by CRF01 AE subtype(35.8%,49 cases),CRF07 BC subtype(4.4%,6 cases)and other types (10.9%,15 cases).Conclusion The current drug resistance rate of HIV-1 in Wenshan Prefecture is increasing.The virulent strains are becoming more complicated and more new recombinant strains are gradually increased.The monitoring should be strengthened for preventing the spread of drug-resistant virulent strains.%目的：了解2014－2015年云南省文山州免费抗病毒治疗获得性免疫缺陷综合征（简称艾滋病）感染者和艾滋病患者HIV-1基因型耐药发生情况及特点。方法收集文山州2014－2015年接受免费抗病毒治疗的艾滋病患者的临床及实验室资料，对抗病毒治疗持续6个月以上、病毒载量仍大于1000 copies／mL的患者进行基因型耐药检测，分析耐药发生情况及耐药毒株流行特点。结果2014－2015年共计176例艾滋病患者发生病毒学失败，共检测基因型耐药176人次，获得可用序列137条。该人群中耐药发生率为62．0％（85／137）。在使用过的药物中，对奈韦拉平（NVP）、依非韦仑（EFV）高度耐药的有62（45．3％）、50（36．5％）；对拉米夫定（3TC）、替诺福韦（TDF）、司他夫定（D4T）、齐多夫定（AZT）高度耐药的情况分别是31（22．6％）、12（8．8％）、8（5．8％）、2（1．5％），对蛋白酶抑制剂（PI）没有出现高度耐药的情况。耐药突变与PI 相关的主要耐药基因突变位点有3例，占2．2％（3／137）；M46IM、T74S和L33I各1例。与核苷类反转录酶抑制剂（NRTI）相关的突变中，突变位点发生频率最高的是 M184V／I，为23．4％（32／137）。与非核苷类反转录酶抑制剂（NNRTI）的突变中，突变位点发生频率最高的是K103N／S，为27％（34／137）。137条完整基因序列中，主要为 CRF08 BC 亚型，共67例（48．9％）；其次是 CRF01 AE 亚型，共49例（35．8％）；CRF07 BC亚型有6例（4．4％）；另外还有15例（10．9％）URFs。结论当前文山州的耐药发生率在增加，毒株正变得复杂化，重组毒株在逐渐增加，应加强监测，防止耐药毒株的传播。
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