Pimenta Ana Teresa Mancini, Correa Isadora Alonso, Melli Patricia Pereira Dos Santos, Abduch Renata, Duarte Geraldo, Couto-Fernandez José Carlos, Quintana Silvana Maria
Department of Gynecology and Obstetrics, Faculdade de Medicina de Ribeirão Preto (FMRP), Universidade de São Paulo (USP), Ribeirão Preto, SP, Brazil.
Fundação Oswaldo Cruz (Fiocruz), Rio de Janeiro, RJ, Brazil.
Sao Paulo Med J. 2018 Mar;136(2):129-135. doi: 10.1590/1516-3180.2017.0233011017.
Increasing genetic diversity of HIV-1 and emergence of drug-resistant mutations may reduce the efficacy of antiretroviral therapy and prophylaxis that are used to prevent mother-to-child transmission. The aim of this study was to assess the genetic diversity and prevalence of drug-resistant mutations among HIV-infected pregnant women.
Cross-sectional study at an outpatient clinic for infectious diseases within gynecology and obstetrics.
This study evaluated the dynamics of HIV-1 subtypes and the prevalence of transmitted and acquired drug-resistant mutations among 38 HIV-infected pregnant women (20 previously exposed to antiretroviral therapy and 18 naive), in Ribeirão Preto (SP), Brazil, between 2010 and 2011. Genotyping was performed by means of molecular sequencing of the protease and reverse transcriptase regions of the HIV-1 pol gene.
Subtype B was identified in 84.2% of the samples, recombinant forms between B and F in 7.9%, subtype F1 in 5.3% and the recombinant form K/F in 2.6%. No mutation associated with transmitted drug resistance was detected in the samples from the naive pregnant women, whereas mutations associated with acquired drug resistance were found in 35.0% of the pregnant women previously exposed to antiretroviral therapy.
The results showed that subtype B predominated, while there was low prevalence of sequences with transmitted drug resistance.
HIV-1基因多样性的增加以及耐药突变的出现可能会降低用于预防母婴传播的抗逆转录病毒疗法和预防措施的疗效。本研究的目的是评估HIV感染孕妇中耐药突变的基因多样性和流行情况。
在妇产科的传染病门诊进行的横断面研究。
本研究评估了2010年至2011年期间巴西里贝朗普雷图（圣保罗州）38名HIV感染孕妇（20名曾接受抗逆转录病毒治疗，18名未接受过治疗）中HIV-1亚型的动态变化以及传播和获得性耐药突变的流行情况。通过对HIV-1 pol基因的蛋白酶和逆转录酶区域进行分子测序来进行基因分型。
84.2%的样本中鉴定出B亚型，7.9%为B和F之间的重组形式，5.3%为F1亚型，2.6%为K/F重组形式。在未接受过治疗的孕妇样本中未检测到与传播性耐药相关的突变，而在曾接受抗逆转录病毒治疗的孕妇中，35.0%发现了与获得性耐药相关的突变。
结果表明B亚型占主导地位，而传播性耐药序列的流行率较低。
