Eshleman S H, Becker-Pergola G, Deseyve M, Guay L A, Mracna M, Fleming T, Cunningham S, Musoke P, Mmiro F, Jackson J B
Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, Maryland 21205, USA.
J Infect Dis. 2001 Oct 1;184(7):914-7. doi: 10.1086/323153. Epub 2001 Aug 13.
In Uganda, the HIV Network for Prevention Trials (HIVNET) 012 study recently demonstrated that single-dose nevirapine (Nvp) prophylaxis is effective for preventing mother-to-child transmission (MTCT) of human immunodeficiency virus type 1 (HIV-1). This exploratory study examines the relationship between HIV-1 subtype, MTCT, and the development of Nvp resistance (Nvp(R)) in women enrolled in HIVNET 012. For 102 women (32 whose infants were HIV-1 infected by age 6-8 weeks and 70 whose infants were uninfected), HIV-1 subtypes included 50 (49%) subtype A, 35 (34%) subtype D, 4 (4%) subtype C, 12 (12%) recombinant subtype, and 1 unclassified. There was no apparent difference in the rate of MTCT among women with subtype A versus D (adjusted odds ratio [OR], 1.24; 95% confidence interval [CI], 0.45-3.43). Nvp(R) mutations were detected more frequently at 6-8 weeks postpartum in women with subtype D than in women with subtype A (adjusted OR, 4.94; 95% CI, 1.21-20.22). Additional studies are needed to further define the relationship between HIV-1 subtype and Nvp(R) among women receiving Nvp prophylaxis.
在乌干达，艾滋病预防试验网络（HIVNET）012研究最近表明，单剂量奈韦拉平（Nvp）预防可有效预防1型人类免疫缺陷病毒（HIV-1）的母婴传播（MTCT）。这项探索性研究调查了参与HIVNET 012的女性中HIV-1亚型、MTCT以及奈韦拉平耐药性（Nvp(R)）产生之间的关系。对于102名女性（32名其婴儿在6至8周龄时感染HIV-1，70名其婴儿未感染），HIV-1亚型包括50例（49%）A亚型、35例（34%）D亚型、4例（4%）C亚型、12例（12%）重组亚型和1例未分类。A亚型与D亚型女性的MTCT发生率无明显差异（调整后的优势比[OR]为1.24；95%置信区间[CI]为0.45 - 3.43）。产后6至8周时，D亚型女性比A亚型女性更频繁地检测到Nvp(R)突变（调整后的OR为4.94；95%CI为1.21 - 20.22）。需要进一步的研究来进一步明确接受Nvp预防的女性中HIV-1亚型与Nvp(R)之间的关系。
