Zidovudine resistance phenotype and risk of perinatal HIV-1 transmission in zidovudine monotherapy-treated mothers with moderately advanced disease.
Zidovudine resistance phenotype and risk of perinatal HIV-1 transmission in zidovudine monotherapy-treated mothers with moderately advanced disease.
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齐多夫定单药治疗的中晚期疾病母亲的齐多夫定耐药表型和围产期 HIV-1 传播风险。
DOI：
10.1097/00126334-200311010-00010
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发表时间：
2003
期刊：
影响因子：
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通讯作者：
WomenandInfantsTransmissionStudyTeam
中科院分区：
文献类型：
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作者：
Bauer,GretaR;Welles,SethL;Colgrove,RobertR;Pitt,Jane;WomenandInfantsTransmissionStudyTeam
在1994年9月参加妇女和婴儿传播研究的74名接受齐多夫定治疗的母亲中，评价了表型齐多夫定耐药与围产期传播的关系。样本中的女性患有中度晚期疾病，中位CD 4+细胞计数为271/[mu] L，中位血浆HIV-1 RNA水平为39，811拷贝/mL。多元logistic回归分析显示，与分娩时齐多夫定耐药（50%抑制浓度[IC 50]，>= 0.1 [mu] M）独立相关的因素包括孕前使用齐多夫定、高对数血浆HIV-1 RNA水平和低CD 4+细胞计数。在74名母亲中，16名（22%）将HIV-1传染给了婴儿。调整破膜持续时间和CD 8+细胞计数后，齐多夫定耐药（IC 50范围，0.012。2 [mu] M）与传播几率增加相关（ORadj，1.25/0.1 [mu] M; 95%置信区间，1.01-1.54），表明产前齐多夫定对预防感染齐多夫定耐药病毒的母亲传播的作用降低。然而，当分析仅限于那些母亲感染的病毒含有齐多夫定耐药突变，表型耐药和传输之间没有关联仍然存在，表明表型可能不会提供显着的额外信息，在预测传输的耐药基因型是已知的。
The association of phenotypic zidovudine resistance with perinatal transmission was evaluated in 74 zidovudine-treated mothers enrolled in the Women and Infants Transmission Study through September 1994. Women in the sample had moderately advanced disease, with a median CD4+ cell count of 271/[mu] L and a median plasma HIV-1 RNA level of 39,811 copies/mL. Factors independently associated with zidovudine resistance at delivery (50% inhibitory concentration [IC50],>= 0.1 [mu] M) in multiple logistic regression included prepregnancy zidovudine use, high log plasma HIV-1 RNA level, and low CD4+ cell count. Of 74 mothers, 16 (22%) transmitted HIV-1 to their infants. After adjustment for duration of membrane rupture and CD8+ cell count, zidovudine resistance (IC50 range, 0.012. 2 [mu] M) was associated with an increased odds of transmission (ORadj, 1.25 per 0.1 [mu] M; 95% confidence interval, 1.01-1.54), suggesting a decreased effect of prenatal zidovudine on preventing transmission in mothers infected with zidovudine-resistant virus. However, when the analysis was limited only to those mothers infected with virus containing zidovudine resistance mutations, no association between phenotypic resistance and transmission remained, indicating that phenotype may not provide significant additional information in predicting transmission where resistance genotype is known.