Drug resistance among HIV-infected pregnant women receiving antiretrovirals for prophylaxis
Drug resistance among HIV-infected pregnant women receiving antiretrovirals for prophylaxis
复制标题
DOI：
10.1097/qad.0b013e328011770b
复制
发表时间：
2007-01-11
期刊：
影响因子：
3.8
通讯作者：
Read, Jennifer S.
中科院分区：
文献类型：
--
作者：
Duran, Adriana S.;Losso, Marcelo H.;Read, Jennifer S.
目的：量化接受抗逆转录病毒治疗(ART)以预防母婴传播的HIV-1感染妇女的原发耐药突变(PRMs)。方法：对在阿根廷、巴哈马、巴西和墨西哥参加前瞻性队列研究(NISDI围产期研究)的HIV-1感染妇女的外周血单核细胞样本进行PRMs检测。符合条件的妇女是在2005年3月之前登记并在当前孕期内被诊断为HIV-1感染，并接受了母婴传播预防并在产后随访6-12周的妇女。结果：在819名妇女中，198人符合资格标准。在登记时，98%的人没有症状，62%的人血浆病毒载量为1000拷贝/毫升，53%的人CD_4+细胞计数=500个细胞/亩L，78%的人接触过抗逆转录病毒药物(平均持续时间为8.0周，95%的可信区间为7.1-8.9)。妊娠期最复杂的ART方案通常是(81%)三药方案[两种核苷逆转录酶抑制剂(NRTI)+一种蛋白酶抑制剂或两种NRTI+一种非核苷逆转录酶抑制剂]。在118名妇女中，有19名(16%)的样本在一个或两个时间点都可以扩增[登记时11/76(14%)；6-12周时14/97(14%)]。PRMS的发生与两个时间点的临床、免疫学或病毒学疾病阶段无关，无论是初治还是入选时暴露，或者怀孕期间接受的抗逆转录病毒药物方案最复杂或数量(P>；0.1)。在两个时间点都有可扩增样本的55名妇女中，I I样本中检出PRM(20%)。结论：在接受母婴传播预防的拉丁美洲和加勒比国家相对健康的HIV-1感染母亲中，PRM的发生率为16.1%。(C)2007年，Lippincott Williams&Wilkins。
Objective: To quantify primary resistance mutations (PRMs) among HIV-1-infected women receiving antiretroviral therapy (ART) for prevention of mother-to-child transmission (MTCT).Methods: Peripheral blood mononuclear cell samples from HIV-1-infected women enrolled in a prospective cohort study in Argentina, the Bahamas, Brazil, and Mexico (NISDI Perinatal Study) were assayed for PRMs. Eligible women were those enrolled by March 2005 and diagnosed with HIV-1 infection during the current pregnancy, and who received ART for MTCT prophylaxis and were followed for 6-12 weeks postpartum.Results: Of 819 women, 198 met the eligibility criteria. At enrollment, 98% were asymptomatic, 62% had plasma viral load < 1000copies/ml, 53% had CD4+ cell count >= 500 cells/mu l, and 78% were ART-exposed (mean duration, 8.0 weeks; 95% confidence interval, 7.1-8.9). The most complex ART regimen during pregnancy was usually (81%) a three-drug regimen [two nucleoside reverse transcriptase inhibitors (NRTIs) + one protease inhibitor or two NRTIs + one non-nucleoside reverse transcriptase inhibitor). PRMs were observed in samples from 19 (16%) of 118 women that were amplifiable at one or both time points [11/76 (14%) at enrollment; 14/97 (14%) at 6-12 weeks]. The occurrence of PRMs was not associated with clinical, immunological, or virological disease stage at either time point, whether ART-naive versus exposed at enrollment, or the most complex or number of antiretroviral drug regimens received during pregnancy (P > 0.1). Of 55 women with amplifiable samples at both time points, PRMs were detected in I I samples (20%).Conclusions: PRMs occurred among 16.1% of relatively healthy HIV-1-infected mothers from Latin American and Caribbean countries receiving MTCT prophylaxis. (c) 2007 Lippincott Williams & Wilkins.