Kurle Swarali N, Gangakhedkar Raman R, Sen Sourav, Hayatnagarkar Shilpa S, Tripathy Srikanth P, Paranjape Ramesh S
Department of Molecular Virology, National AIDS Research Institute, Pune, India.
AIDS Res Hum Retroviruses. 2007 May;23(5):682-5. doi: 10.1089/aid.2006.0167.
A feasibility study for providing single-dose nevirapine (SD-NVP) prophylaxis for prevention of mother-to-child transmission (PMTCT) of HIV infection provided an opportunity to study the emergence of nonnucleoside reverse transcriptase inhibitor (NNRTI) resistance mutations as a result of single-dose administration. The study aimed at the detection of NNRTI drug resistance mutations arising as a result of SD-NVP. A total of 19 and 13 samples collected at 48 h and 2 months postpartum, respectively, from infants that were given SD-NVP were studied for the presence of NNRTI drug resistance mutations by PCR amplification and sequencing of the HIV-1 pol gene using HIV proviral DNA. The drug resistance mutational analysis of final sequences was carried out using the Stanford University HIV Drug Resistance database (http://hivdb.stanford.edu/hiv). Mutations associated with NNRTI drug resistance were observed in two (10.5%) and six (46.15%) samples at 48 h and at 2 months, respectively. K103N, one of the most common mutations, was not observed in any of the samples. The emergence of NVP resistance must be weighed against the simplicity, efficacy, and cost effectiveness of SD-NVP prophylaxis in PMTCT settings in developing countries.
一项关于提供单剂量奈韦拉平（SD-NVP）预防艾滋病毒母婴传播（PMTCT）的可行性研究，为研究单剂量给药导致的非核苷类逆转录酶抑制剂（NNRTI）耐药突变的出现提供了契机。该研究旨在检测因SD-NVP产生的NNRTI耐药突变。分别从接受SD-NVP的婴儿产后48小时和2个月收集了19份和13份样本，通过使用HIV前病毒DNA对HIV-1 pol基因进行PCR扩增和测序，研究NNRTI耐药突变的存在情况。使用斯坦福大学HIV耐药数据库（http://hivdb.stanford.edu/hiv）对最终序列进行耐药突变分析。在48小时和2个月时，分别在两份（10.5%）和六份（46.15%）样本中观察到与NNRTI耐药相关的突变。最常见的突变之一K103N在任何样本中均未观察到。在发展中国家PMTCT环境中，必须权衡奈韦拉平耐药性的出现与SD-NVP预防的简易性、有效性和成本效益。
