University of Washington Health Alliance International.
University of Washington Seattle Children's Research Institute, Seattle, Washington;
J Infect Dis. 2014 Aug 15;210(4):641-5. doi: 10.1093/infdis/jiu130. Epub 2014 Mar 4.
Acquisition of nevirapine (NVP)-resistant human immunodeficiency virus type 1 (HIV-1) by breast-feeding infants after receipt of single-dose NVP to prevent mother-to-child transmission is not well defined. A prospective observational study of 307 infants evaluated the rate of breast milk transmission of NVP-resistant HIV and the concentrations of mutants over time. NVP resistance was detected in 9 of 24 infants (37.5%; 95% confidence interval, 18.8%-59.4%) infected via breast milk. Eight had a pure mutant HIV population at the time infection was first detected, and majority mutant populations persisted in all 6 infants with follow-up specimens. Infection of breast-feeding infants with NVP-resistant HIV resulted in mutants persisting as the dominant virus, which may indefinitely compromise treatment with NVP-based antiretroviral regimens.
通过单次接受奈韦拉平（NVP）预防母婴传播而获得的 NVP 耐药性人类免疫缺陷病毒 1 型（HIV-1）的母乳喂养婴儿的获得情况尚未明确。一项对 307 名婴儿进行的前瞻性观察性研究评估了 NVP 耐药性 HIV 通过母乳传播的速度以及突变体随时间的浓度。通过母乳喂养感染的 24 名婴儿中有 9 名（37.5%；95%置信区间，18.8%-59.4%）检测到 NVP 耐药。其中 8 人在首次检测到感染时就存在纯突变 HIV 种群，在所有 6 名具有随访标本的婴儿中，多数突变种群持续存在。用 NVP 耐药性 HIV 感染母乳喂养婴儿会导致突变体持续成为主要病毒，这可能会无限期地影响基于 NVP 的抗逆转录病毒方案的治疗。
