Resistance mutations in HIV-1 infected pregnant women and their infants receiving antiretrovirals to prevent HIV-1 vertical transmission in China
Resistance mutations in HIV-1 infected pregnant women and their infants receiving antiretrovirals to prevent HIV-1 vertical transmission in China
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DOI：
10.1258/ijsa.2008.008480
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发表时间：
2009-04-01
影响因子：
1.4
通讯作者：
Wang, Q.
中科院分区：
文献类型：
--
作者：
Han, J.;Wang, L.;Wang, Q.
本研究的目的是评估中国HIV-1感染孕妇的耐药基线以及她们及其婴儿在接受单剂量奈韦拉平（sdNVP）或齐多夫定加sdNVP（ZDV-sdNVP）预防母婴传播（PMTCT）后出现的耐药性（DR）。这项前瞻性研究跟踪了 62 名未接受过药物治疗的 HIV-1 感染母亲及其婴儿，她们接受了 sdNVP 进行 PMTCT，另外还有 18 名接受了 ZDV-sdNVP。基线时，8.8% (7/80) 的孕妇检测到原发性 DR。两名 (2.5%) 女性患有与核苷逆转录酶抑制剂 (NRTI) 相关的突变。六名 (7.5%) 女性携带与非核苷逆转录酶抑制剂 (NNRTI) 相关的突变。未检测到蛋白酶抑制剂 (PI) DR。 sdNVP和ZDV-sdNVP方案选择的感染母亲的DR率分别为16.3%和0%。 sdNVP 后出现 DR 的女性在分娩时的 CD4 细胞计数低于 sdNVP 后未出现 DR 的女性（1178 vs.364 个细胞/mm(3)，p < 0.05）。具有基线耐药性的女性的垂直传播率与无基线耐药性的女性相似（1/7 vs. 3/73，P > 0.05）。研究表明 sdNVP 后的 NVP 耐药性与分娩时 CD4 细胞计数相关。 ZDV-sdNVP方案在预防NNRTI相关DR的发生方面比sdNVP方案更有意义。
The objective of this study was to assess the resistance baseline in HIV-1-infected pregnant women in China and the emergence of drug resistance (DR) among them and their infants after receiving single-dose nevirapine (sdNVP) or zidovudine plus sdNVP (ZDV-sdNVP) for the prevention of mother-to-child transmission (PMTCT). The prospective study followed 62 drug-naive HIV-1-infected mothers and their infants who received sdNVP for PMTCT and 18 who received ZDV-sdNVP. Primary DR was detected in 8.8% (7/80) of pregnant women at baseline. Two (2.5%) women had mutations associated with nucleoside reverse transcriptase inhibitors (NRTI). Six (7.5%) women harboured mutations associated with non-nucleoside reverse transcriptase inhibitors (NNRTI). No protease inhibitor (PI) DR was detected. The DR rates in infected mothers selected by sdNVP and ZDV-sdNVP regimen were 16.3% and 0%, respectively. Women with the emergence of DR after sdNVP had lower CD4 cell counts at delivery than women without DR after sdNVP (1178 vs.364 cells/mm(3), p < 0.05). The vertical transmission rate in women with baseline resistance was similar to that in women without baseline resistance (1/7 vs. 3/73, P > 0.05). The study indicates that NVP resistance after sdNVP was associated with CD4 cell count at delivery. ZDV-sdNVP regimen was of more significance in the prevention of the emergence of NNRTI-related DR than sdNVP.