Luz Aldicléya Lima, Lima Kledoaldo, Leal Élcio, Pessôa Fabrício Silva, de Oliveira Ribeiro Geovani, de Andrade Arrais Rosa Cláudia Regina, de Sousa Marcos Davi Gomes, Farias Pablo Cantalice Santos, Lacerda Heloisa Ramos
Programa de Pós-graduação em Medicina Tropical, Universidade Federal de Pernambuco, Recife, Pernambuco, Brasil.
Hospital das Clínicas, Universidade Federal de Pernambuco, Recife, Pernambuco, Brasil.
BMC Infect Dis. 2025 Jul 1;25(1):811. doi: 10.1186/s12879-025-11230-9.
This study aimed to describe the transmission of drug-resistant HIV-1 variants and phylogenetic characterisation of viral strains in mother-child pairs from the cities of Recife and São Luís, located in the Northeast region of Brazil, in 2007-2022.
This study included 15 mother-child pairs with confirmed vertical transmission of HIV-1. The genotyping sequences were provided by the Brazilian Ministry of Health. The analyses included descriptions of antiretroviral resistance mutation profiles of the mothers and children, subtype determination, and phylogenetic analyses.
Seven mother-child pairs exhibited similar mutation profiles, with three showing no mutations and four displaying similar resistance mutations to the nucleoside reverse transcriptase inhibitor (NRTI) and non-nucleoside reverse transcriptase inhibitor (NNRTI) drug classes. Among four pairs, mutation similarities were observed for only one antiretroviral drug class. In the remaining four pairs, distinct mutation profiles were noted, with two children having mutations in two or three drug classes and their mothers exhibiting no or one mutation. Among the eight pairs with tests obtained within the first four years after birth, six of them had very similar mutation profiles. Among the seven pairs with exams obtained five years or more after birth, four pairs presented very different DRAM profiles. Mutations conferring resistance to efavirenz, nevirapine, lamivudine, abacavir, and didanosine were frequently observed in children and mothers. Thirteen pairs (86.6%) were identified as having HIV-1 subtype B, while two (13.3%) were identified as having HIV-1 subtype F1.
Differences in mutation profiles and antiretroviral resistance for NRTI and NNRTI drug classes were observed in half of the mother-child pairs, emphasising the importance of individualised therapeutic strategies.
本研究旨在描述2007年至2022年期间，位于巴西东北部累西腓市和圣路易斯市的母婴对中耐药HIV-1变异株的传播情况以及病毒株的系统发育特征。
本研究纳入了15对确诊为HIV-1垂直传播的母婴对。基因分型序列由巴西卫生部提供。分析内容包括对母亲和儿童抗逆转录病毒耐药突变谱的描述、亚型确定以及系统发育分析。
7对母婴对表现出相似的突变谱，其中3对无突变，4对显示出对核苷类逆转录酶抑制剂（NRTI）和非核苷类逆转录酶抑制剂（NNRTI）药物类别相似的耐药突变。在4对母婴对中，仅观察到一种抗逆转录病毒药物类别的突变相似性。在其余4对母婴对中，注意到不同的突变谱，其中2名儿童在两到三类药物中有突变，而他们的母亲无突变或有一个突变。在出生后头四年内进行检测的8对母婴对中，其中6对具有非常相似的突变谱。在出生五年或更久后进行检测的7对母婴对中，4对呈现出非常不同的耐药相关氨基酸突变（DRAM）谱。在儿童和母亲中经常观察到对依非韦伦、奈韦拉平、拉米夫定、阿巴卡韦和去羟肌苷耐药的突变。13对（86.6%）被鉴定为HIV-1 B亚型，而2对（13.3%）被鉴定为HIV-1 F1亚型。
在一半的母婴对中观察到NRTI和NNRTI药物类别的突变谱和抗逆转录病毒耐药性存在差异，强调了个体化治疗策略的重要性。
