University of Washington, Seattle, Washington, USA.
J Infect Dis. 2012 Jun 15;205(12):1811-5. doi: 10.1093/infdis/jis282. Epub 2012 Apr 5.
Single-dose nevirapine (sdNVP) given to prevent mother-to-child-transmission of HIV-1 selects NVP-resistance. Short-course zidovudine (ZDV) was hypothesized to lower rates of NVP-resistance. HIV-1 infected pregnant women administered sdNVP with or without short-course ZDV were assessed for HIV-1 mutations (K103N, Y181C, G190A, and V106M) prior to delivery and postpartum. Postpartum NVP-resistance was lower among 31 taking ZDV+sdNVP compared to 33 taking only sdNVP (35.5% vs. 72.7%; χ2 P = .003). NVP mutants decayed to <2% in 24/35 (68.6%) at a median 6 months postpartum, with no differences based on ZDV use (logrank P = .99). Short-course ZDV was associated with reduced NVP-resistance mutations among women taking sdNVP.
单剂量奈韦拉平（sdNVP）用于预防 HIV-1 的母婴传播会选择出对 NVP 的耐药性。短程齐多夫定（ZDV）被假设可以降低 NVP 耐药率。对接受 sdNVP 加或不加短程 ZDV 的 HIV-1 感染孕妇在分娩前和产后进行 HIV-1 突变（K103N、Y181C、G190A 和 V106M）评估。与仅接受 sdNVP 的 33 名孕妇相比，接受 ZDV+sdNVP 的 31 名孕妇的产后 NVP 耐药率较低（35.5% vs. 72.7%；χ2 P =.003）。在产后 6 个月时，35 名患者中有 24 名（68.6%）的 NVP 突变体衰减至<2%，ZDV 的使用没有差异（对数秩检验 P =.99）。对于接受 sdNVP 的妇女，短程 ZDV 与减少 NVP 耐药性突变有关。
