布基纳法索预防母婴HIV-1传播：通过聚合酶链反应评估垂直传播、亚型的分子特征分析及抗逆转录病毒药物耐药性测定
Prevention of mother-to-child HIV-1 transmission in Burkina Faso: evaluation of vertical transmission by PCR, molecular characterization of subtypes and determination of antiretroviral drugs resistance.
作者信息
Sagna Tani, Bisseye Cyrille, Compaore Tegewende R, Kagone Therese S, Djigma Florencia W, Ouermi Djeneba, Pirkle Catherine M, Zeba Moctar T A, Bazie Valerie J T, Douamba Zoenabo, Moret Remy, Pietra Virginio, Koama Adjirita, Gnoula Charlemagne, Sia Joseph D, Nikiema Jean-Baptiste, Simpore Jacques
机构信息
Biomolecular Research Centre Pietro Annigoni (CERBA/LABIOGENE), University of Ouagadougou, Burkina Faso, West Africa; Institute of Research in Health Sciences, IRSS, Bobo-Dioulasso, Burkina Faso;
Biomolecular Research Centre Pietro Annigoni (CERBA/LABIOGENE), University of Ouagadougou, Burkina Faso, West Africa; Laboratory of Molecular and Cellular Biology, University of Sciences and Techniques of Masuku (USTM), Franceville, Gabon.
出版信息
Glob Health Action. 2015 Jan 27;8:26065. doi: 10.3402/gha.v8.26065. eCollection 2015.
BACKGROUND
Vertical human immunodeficiency virus (HIV) transmission is a public health problem in Burkina Faso. The main objective of this study on the prevention of mother-to-child HIV-1 transmission was to determine the residual risk of HIV transmission in infants born to mothers receiving highly active antiretroviral therapy (HAART). Moreover, we detect HIV antiretroviral (ARV) drug resistance among mother-infant pairs and identify subtypes and circulating recombinant forms (CRF) in Burkina Faso.
DESIGN
In this study, 3,215 samples of pregnant women were analyzed for HIV using rapid tests. Vertical transmission was estimated by polymerase chain reaction in 6-month-old infants born to women who tested HIV positive. HIV-1 resistance to ARV, subtypes, and CRFs was determined through ViroSeq kit using the ABI PRISM 3,130 sequencer.
RESULTS
In this study, 12.26% (394/3,215) of the pregnant women were diagnosed HIV positive. There was 0.52% (2/388) overall vertical transmission of HIV, with rates of 1.75% (2/114) among mothers under prophylaxis and 0.00% (0/274) for those under HAART. Genetic mutations were also isolated that induce resistance to ARV such as M184V, Y115F, K103N, Y181C, V179E, and G190A. There were subtypes and CRF of HIV-1 present, the most common being: CRF06_CPX (58.8%), CRF02_AG (35.3%), and subtype G (5.9%).
CONCLUSIONS
ARV drugs reduce the residual rate of HIV vertical transmission. However, the virus has developed resistance to ARV, which could limit future therapeutic options when treatment is needed. Resistance to ARV therefore requires a permanent interaction between researchers, physicians, and pharmacists, to strengthen the network of monitoring and surveillance of drug resistance in Burkina Faso.
背景
在布基纳法索，人类免疫缺陷病毒（HIV）垂直传播是一个公共卫生问题。这项预防母婴HIV-1传播研究的主要目的是确定接受高效抗逆转录病毒治疗（HAART）的母亲所生婴儿中HIV传播的残余风险。此外，我们检测母婴对中的HIV抗逆转录病毒（ARV）耐药性，并确定布基纳法索的HIV亚型和循环重组型（CRF）。
设计
在本研究中，使用快速检测法对3215份孕妇样本进行HIV检测。通过聚合酶链反应对HIV检测呈阳性的女性所生6个月大婴儿的垂直传播情况进行评估。使用ABI PRISM 3130测序仪通过ViroSeq试剂盒确定HIV-1对ARV的耐药性、亚型和CRF。
结果
在本研究中，12.26%（394/3215）的孕妇被诊断为HIV阳性。HIV总体垂直传播率为0.52%（2/388），接受预防治疗的母亲中传播率为1.75%（2/114），接受HAART治疗的母亲中传播率为0.00%（0/274）。还分离出了对ARV产生耐药性的基因突变，如M184V、Y115F、K103N、Y181C、V179E和G190A。存在HIV-1的亚型和CRF，最常见的是：CRF06_CPX（58.8%）、CRF02_AG（35.3%）和G亚型（5.9%）。
结论
抗逆转录病毒药物降低了HIV垂直传播的残余率。然而，该病毒已对抗逆转录病毒药物产生耐药性，这可能会限制未来需要治疗时的治疗选择。因此，抗逆转录病毒药物耐药性问题需要研究人员、医生和药剂师之间持续互动，以加强布基纳法索耐药性监测网络。
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