卡氏肺孢子虫细胞色素b突变与艾滋病患者接受阿托伐醌治疗有关。

Pneumocystis carinii cytochrome b mutations are associated with atovaquone exposure in patients with AIDS.

作者信息

Kazanjian P, Armstrong W, Hossler P A, Lee C H, Huang L, Beard C B, Carter J, Crane L, Duchin J, Burman W, Richardson J, Meshnick S R

机构信息

Department of Internal Medicine, University of Michigan Health System, 1500 E. Medical Center Dr., Rm. 3120B TC, Ann Arbor, MI 48109-0378, USA.

出版信息

J Infect Dis. 2001 Mar 1;183(5):819-22. doi: 10.1086/318835. Epub 2001 Feb 1.

DOI:10.1086/318835

PMID:11181161

Abstract

This retrospective cohort study was conducted to determine whether Pneumocystis carinii cytochrome b gene mutations in patients with AIDS and P. carinii pneumonia (PCP) are associated with atovaquone exposure. Portions of the P. carinii cytochrome b genes that were obtained from 60 patients with AIDS and PCP from 6 medical centers between 1995 and 1999 were amplified and sequenced by using polymerase chain reaction. Fifteen patients with previous atovaquone prophylaxis or treatment exposure were matched with 45 patients with no atovaquone exposure. Cytochrome b coenzyme Q binding site mutations were observed in 33% of isolates from patients exposed to atovaquone, compared with 6% from those who were not (P=.018). There was no difference in survival 1 month after treatment between patients with or without cytochrome b mutations (P=.14). Thus, cytochrome b mutations are significantly more common in patients with AIDS and PCP with atovaquone exposure, but the clinical significance of these mutations remains unknown.

摘要

本回顾性队列研究旨在确定艾滋病合并卡氏肺孢子虫肺炎（PCP）患者的卡氏肺孢子虫细胞色素b基因突变是否与阿托伐醌暴露有关。1995年至1999年间，从6个医疗中心的60例艾滋病合并PCP患者中获取卡氏肺孢子虫细胞色素b基因片段，采用聚合酶链反应进行扩增和测序。15例曾接受阿托伐醌预防或治疗的患者与45例未接受阿托伐醌暴露的患者进行匹配。在接受阿托伐醌暴露患者的分离株中，33%观察到细胞色素b辅酶Q结合位点突变，而未暴露患者中这一比例为6%（P = 0.018）。有或无细胞色素b基因突变的患者治疗后1个月的生存率无差异（P = 0.14）。因此，细胞色素b基因突变在艾滋病合并PCP且有阿托伐醌暴露的患者中明显更常见，但这些突变的临床意义尚不清楚。