Briand Nelly, Pornprasert Sakorn, Ngo-Giang-Huong Nicole, Galactéros Fréderic, Pissard Serge, Tatu Thanusak, Sanguansermsri Torpong, Jourdain Gonzague, Lallemant Marc, Le Coeur Sophie
Institut National d'Etudes Démographiques, Paris, France.
Antivir Ther. 2009;14(1):117-22.
To investigate a possible interaction between alpha-thalassaemia, beta-thalassaemia and haemoglobin-E trait and the haematological parameters of HIV type-1 (HIV-1)-infected pregnant women receiving zidovudine prophylaxis for the prevention of mother-to-child HIV-1 transmission in Thailand.
The study sample was composed of HIV-1-infected pregnant women receiving zidovudine (300 mg twice daily) from 28 weeks of gestational age to delivery as part of the Perinatal HIV Prevention Trial (PHPT-1), a large trial investigating zidovudine use in pregnancy. These women were randomly selected and screened for haemoglobin abnormalities. Haemoglobin levels, haematocrit and erythrocyte, leukocyte, absolute neutrophil and absolute lymphocyte counts were measured at 26, 32 and 35 weeks of gestation and at delivery. PCR genotyping techniques were used to screen for haemoglobin abnormalities, which included alpha-thalassaemia-1 Southeast Asian type deletion, beta-thalassaemia mutation (codons 41/42 [-TCTT], codon 17 [A-->T], intervening sequence-I nucleotide 1 [G-->T], codons 71/72 [+A]) and haemoglobin-E trait. The evolution of haematological parameters between 26 weeks and delivery was compared according to thalassaemia carriage using linear mixed models adjusted for baseline sociodemographic characteristics, HIV clinical stage, CD4+ T-cell count and viral load.
At baseline, women with thalassaemia or haemoglobin-E trait had significantly lower haemoglobin level and red blood cell counts than women with no haemoglobin abnormalities, whereas absolute neutrophil and leukocyte counts were significantly higher. Exposure to zidovudine until delivery did not increase this difference.
Zidovudine exposure did not appear to have increased haematological toxicity in HIV-1-infected pregnant women with thalassaemia.
在泰国，为调查α地中海贫血、β地中海贫血和血红蛋白E性状之间可能存在的相互作用，以及接受齐多夫定预防母婴传播HIV-1感染的孕妇的血液学参数。
研究样本由参与围产期HIV预防试验（PHPT-1）的HIV-1感染孕妇组成，她们从孕28周开始至分娩接受齐多夫定（每日两次，每次300毫克），这是一项关于孕期使用齐多夫定的大型试验。这些妇女被随机选取并筛查血红蛋白异常情况。在妊娠26、32和35周以及分娩时测量血红蛋白水平、血细胞比容以及红细胞、白细胞、绝对中性粒细胞和绝对淋巴细胞计数。采用聚合酶链反应基因分型技术筛查血红蛋白异常情况，包括东南亚型α地中海贫血-1缺失、β地中海贫血突变（密码子41/42[-TCTT]、密码子17[A→T]、内含子-I核苷酸1[G→T]、密码子71/72[+A]）和血红蛋白E性状。根据地中海贫血携带情况，使用针对基线社会人口统计学特征、HIV临床分期、CD4+T细胞计数和病毒载量进行调整的线性混合模型，比较26周与分娩之间血液学参数的变化。
在基线时，患有地中海贫血或血红蛋白E性状的妇女的血红蛋白水平和红细胞计数显著低于无血红蛋白异常的妇女，而绝对中性粒细胞和白细胞计数显著更高。直至分娩时暴露于齐多夫定并未增加这种差异。
对于感染HIV-1且患有地中海贫血的孕妇，暴露于齐多夫定似乎并未增加血液学毒性。
