Nevirapine (NVP) resistance in women with HIV-1 subtype C, compared with subtypes A and D, after the administration of single-dose NVP
Nevirapine (NVP) resistance in women with HIV-1 subtype C, compared with subtypes A and D, after the administration of single-dose NVP
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DOI：
10.1086/430764
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发表时间：
2005-07-01
影响因子：
6.4
通讯作者：
Taha, T
中科院分区：
文献类型：
--
作者：
Eshleman, SH;Hoover, DR;Taha, T
Objective.在乌干达的人类免疫缺陷病毒（HIV）预防试验网络（HIVNET）012试验中，奈韦拉平单次给药（SD-NVP）后6-8周，HIV-1 D亚型女性中检测到NVP耐药突变的发生率高于A亚型女性。在这里，我们评估的NVP耐药突变率的妇女亚型C。使用ViroSeq HIV-1基因分型系统检测NVP耐药突变。在马拉维NVP和齐多夫定试验中，C亚型妇女中有任何NVP耐药突变的比例（45/65 [69.2%]）高于HIVNET 012试验中A亚型妇女（28/144 [19.4%]; P < .0001）或D亚型妇女（35/97 [36.1%]; P < .0001）。在多变量模型中，（C与A：比值比[OR]，8.73 [95%置信区间{CI}，4.29-17.76]; C与D：OR，3.38 [95% CI，1.65-6.93]）和分娩时的病毒载量（OR，2.35 [95%CI，1.62-3.40]）独立预测NVP耐药突变，但母亲年龄、产次和SD-NVP与6-8周访视之间的时间不能预测。SD-NVP后NVP耐药突变率在HIV-1C亚型女性中显著高于A或D亚型女性。需要研究来评估这一发现的临床意义。
Objective. In the Human Immunodeficiency Virus (HIV) Network for Prevention Trials (HIVNET) 012 trial in Uganda, 6-8 weeks after single-dose nevirapine (SD-NVP), NVP resistance mutations were detected at a higher rate in women with HIV-1 subtype D than in women with subtype A. Here, we evaluate the rate of NVP resistance mutations in women with subtype C.Methods. NVP resistance mutations were detected using the ViroSeq HIV-1 Genotyping System.Results. The portion of women with any NVP resistance mutation was higher in those with subtype C (45/65 [69.2%] in the NVP and zidovudine trial, Malawi) than in those in the HIVNET 012 trial with either subtype A (28/144 [19.4%]; P < .0001) or subtype D (35/97 [36.1%]; P < .0001). In a multivariate model, subtype (C vs. A: odds ratio [OR], 8.73 [95% confidence interval {CI}, 4.29-17.76]; C vs. D: OR, 3.38 [95% CI, 1.65-6.93]) and viral load at delivery (OR, 2.35 [ 95% CI, 1.62-3.40]) independently predicted NVP resistance mutations, but maternal age, parity, and time between SD-NVP and the 6-8-week visit did not.Conclusions. The rate of NVP resistance mutations after SD-NVP was significantly higher in women with HIV-1 subtype C than in women with subtype A or D. Studies are needed to assess the clinical significance of this finding.