Ekpini René-Anatole, Nkengasong John N, Sibailly Toussaint, Maurice Chantal, Adjé Christiane, Monga Ben B, Roels Thierry H, Greenberg Alan E, Wiktor Stefan Z
Projet RETRO-CI, BP-1712, 01 Abidjan, Côte d'Ivoire.
AIDS. 2002 Mar 8;16(4):625-30. doi: 10.1097/00002030-200203080-00015.
To describe changes in HIV-1 plasma viral load (VL) and CD4 cell counts and to assess zidovudine resistance associated with a short course of oral zidovudine during late pregnancy.
From April 1996 to February 1998 in Abidjan, Côte d'Ivoire, 280 HIV-1-seropositive women were randomly assigned at 36 weeks' gestation to receive zidovudine (300 mg) or placebo twice a day, and then one tablet every 3 h from the onset of labor until delivery. Blood samples obtained every 2 weeks until delivery, then at 2 and 4 weeks, and 3 or 6 months after delivery were tested from selected women based on duration of therapy for plasma VL and CD4 cell counts, and samples from 20 women in the zidovudine group were tested by DNA sequencing for the presence of zidovudine resistance mutations.
In the zidovudine group, the median reduction in plasma VL (log(10) copies/ml) was -0.48 after 2 weeks (P = 0.02 versus placebo), -0.48 after 4 weeks (P = 0.06), -0.80 after 6 weeks (P = 0.29) of treatment, -0.12 at delivery (P = 0.11), +0.21 at 2 weeks (P = 0.83), +0.17 at 4 weeks (P = 0.69), and +0.21 at 3 months (P = 0.56) postpartum. Median CD4 cell counts were higher in the zidovudine than in the placebo group after 2, 4, and 6 weeks of treatment (P < 0.05). No mutations associated with zidovudine resistance were identified in any of the samples tested.
These findings suggest that a short course of zidovudine has no adverse HIV-1 virological consequences for the mother.
描述妊娠晚期接受短期口服齐多夫定治疗期间，HIV-1血浆病毒载量（VL）和CD4细胞计数的变化，并评估与齐多夫定耐药相关的情况。
1996年4月至1998年2月在科特迪瓦的阿比让，280名HIV-1血清学阳性的孕妇在妊娠36周时被随机分配，每天两次接受齐多夫定（300毫克）或安慰剂治疗，然后从临产开始至分娩每3小时服用一片。在选定的妇女中，每2周采集一次血样直至分娩，然后在产后2周和4周以及3或6个月时采集血样，检测血浆VL和CD4细胞计数，并对齐多夫定组的20名妇女的样本进行DNA测序，以检测是否存在齐多夫定耐药突变。
在齐多夫定组中，治疗2周后血浆VL的中位数降低（log(10)拷贝/毫升）为-0.48（与安慰剂相比，P = 0.02），4周后为-0.48（P = 0.06），6周后为-0.80（P = 0.29），分娩时为-0.12（P = 0.11），产后2周为+0.21（P = 0.83），4周为+0.17（P = 0.69），3个月为+0.21（P = 0.56）。治疗2、4和6周后，齐多夫定组的CD4细胞计数中位数高于安慰剂组（P < 0.05）。在任何检测的样本中均未发现与齐多夫定耐药相关的突变。
这些发现表明，短期使用齐多夫定对母亲没有不良的HIV-1病毒学影响。
