Research Department, Infectious Diseases Institute, College of Health Sciences, Makerere University, P. O. Box 22418, Kampala, Uganda.
School of Medicine, Infectious Diseases, Indiana University, Indianapolis, IN, USA.
AIDS Res Ther. 2023 Mar 31;20(1):20. doi: 10.1186/s12981-023-00514-2.
We investigated the association between CYP2B6 polymorphisms and efavirenz drug resistance among women living with HIV who started on antiretroviral therapy during pregnancy and with high viremia during post-partum.
This was a cross-sectional study of women with viral loads greater than 1000 copies/ml who were at least 6 weeks postpartum. Sanger sequencing was used to detect resistant mutations, as well as host genotyping, and efavirenz resistance was compared among the metabolizer genotypes.
Over the course of one year (July 2017-July 2018), 322 women were screened, with 110 (34.2%) having viral loads of 1000 copies/ml and 62 having whole blood available for genotyping. Fifty-nine of these women had both viral resistance and human host genotypic results. Efavirenz resistance according to metabolizer genotype was; 47% in slow, 34% in extensive and 28% in intermediate metabolizers, but the difference was not statistically significant due to the small sample size.
There was no statistically significant difference in EFV resistance between EFV metabolizer genotypes in women who started antiretroviral therapy during pregnancy and had high viremia in the postpartum period. However, a numerical trend was discovered, which calls for confirmation in a large, well-designed, statistically powered study.
我们研究了 CYP2B6 多态性与在孕期开始抗逆转录病毒治疗且产后高病毒血症的 HIV 感染者中依非韦伦耐药之间的关联。
这是一项在产后至少 6 周且病毒载量大于 1000 拷贝/ml 的女性中进行的横断面研究。我们采用 Sanger 测序检测耐药突变，同时进行宿主基因分型，并比较代谢酶基因型之间的依非韦伦耐药情况。
在一年的时间里（2017 年 7 月至 2018 年 7 月），共筛查了 322 名女性，其中 110 名（34.2%）的病毒载量为 1000 拷贝/ml，62 名有全血可供基因分型。在这 59 名女性中，有 59 名女性同时具有病毒耐药和人类宿主基因型结果。根据代谢酶基因型，依非韦伦耐药率分别为：慢代谢者为 47%，广泛代谢者为 34%，中间代谢者为 28%，但由于样本量小，差异无统计学意义。
在孕期开始抗逆转录病毒治疗且产后高病毒血症的女性中，依非韦伦代谢酶基因型与 EFV 耐药之间无统计学显著差异。然而，我们发现了一个数值趋势，需要在一项设计良好、统计学上有足够效力的大型研究中加以证实。
