Saint Petersburg Pasteur Institute, 19710 St. Petersburg, Russia.
HIV/AIDS Laboratory, Pasteur Institute, Ho Chi Minh City 700000, Vietnam.
Viruses. 2023 Sep 27;15(10):2008. doi: 10.3390/v15102008.
According to the latest data released by UNAIDS, the global number of people living with HIV (PLHIV) in 2021 was 38.4 million, with 1.5 million new HIV infections. In different countries, a significant proportion of these cases occur in the adult fertile population aged 15-49 years. According to UNAIDS, Vietnam had a national HIV prevalence of 0.3% of the total population at the end of 2019, with approximately 230,000 PLHIV. The most effective way to prevent mother-to-child transmission of HIV is ART to reduce maternal viral load. HIV-infected pregnant women should undergo monthly monitoring, especially before the expected date of delivery. The aim of our work was to analyze subtypic structure and drug-resistant variants of HIV in pregnant women in Ho Chi Minh City. The study material was blood plasma samples from HIV-infected pregnant women: 31 women showed virological failure of ART, and 30 women had not previously received therapy. HIV-1 genotyping and mutation detection were performed based on analysis of the nucleotide sequences of the gene region. More than 98% of sequences genotyped as HIV-1 sub-subtype CRF01_AE. When assessing the occurrence of drug resistance mutations, genetic resistance to any drug was detected in 74.41% (95% CI: 62.71-85.54%) of patients. These included resistance mutations to protease inhibitors in 60.66% (95% CI: 47.31-72.93%) of patients, to NRTIs in 8.20% (95% CI: 2.72-18.10%), and to NNRTIs in 44.26% (95% CI: 31.55-57.52%). Mutations associated with NRTI (2) and NNRTI (8) resistance as well as PI mutations (12), including minor ones, were identified. The high prevalence of drug resistance mutations found in this study among pregnant women, both in therapeutically naive individuals and in patients with virological failure of ART, indicates that currently used regimens in Vietnam are insufficient to prevent vertical HIV infection.
根据艾滋病署发布的最新数据，2021 年全球艾滋病毒感染者（PLHIV）人数为 3840 万，新增艾滋病毒感染病例 150 万。在不同国家，这些病例中有很大一部分发生在 15-49 岁的成年育龄人群中。根据艾滋病署的数据，截至 2019 年底，越南全国艾滋病毒感染率为总人口的 0.3%，约有 23 万艾滋病毒感染者。预防母婴传播艾滋病毒的最有效方法是采用抗逆转录病毒疗法降低母婴病毒载量。感染艾滋病毒的孕妇应每月接受监测，尤其是在预计分娩日期之前。我们的工作目的是分析胡志明市孕妇的 HIV 亚型结构和耐药变异体。研究材料为感染艾滋病毒的孕妇的血浆样本：31 名妇女显示出抗逆转录病毒治疗的病毒学失败，30 名妇女以前未接受过治疗。根据基因区核苷酸序列分析，进行 HIV-1 基因分型和突变检测。超过 98%的序列被鉴定为 HIV-1 次亚群 CRF01_AE。在评估耐药突变的发生时，在 74.41%（95%可信区间：62.71-85.54%）的患者中检测到对任何药物的遗传耐药性。这些包括蛋白酶抑制剂耐药突变 60.66%（95%可信区间：47.31-72.93%），核苷逆转录酶抑制剂耐药突变 8.20%（95%可信区间：2.72-18.10%）和非核苷逆转录酶抑制剂耐药突变 44.26%（95%可信区间：31.55-57.52%）。确定了与核苷（2）和非核苷（8）耐药相关的突变以及蛋白酶抑制剂（12）突变，包括次要突变。在接受抗逆转录病毒治疗的患者和未接受抗逆转录病毒治疗的患者中，孕妇中发现的耐药突变如此普遍，这表明越南目前使用的方案不足以预防垂直艾滋病毒感染。
