马拉维近期感染艾滋病毒的孕妇对非核苷类逆转录酶抑制剂的耐药性水平

IF 1.3 4区 医学 Q4 INFECTIOUS DISEASES
George Bello, Matthew Kagoli, Sikhona Chipeta, Andrew Auld, Joy C-W Chang, Joshua R DeVos, Evelyn Kim, Jonathan Mkungudza, Danielle Payne, Michael Eliya, Rose Nyirenda, Andreas Jahn, Taziona Mzumara, Bernard Mvula, Sufia Dadabhai, Ireen Namakhoma, Yusuf Babaye, Amalia Giron, Michael R Jordan, Silvia Bertagnolio, Gabrielle O'Malley, Nellie Wadonda-Kabondo
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引用次数: 1

摘要

背景:关于新诊断的艾滋病毒感染者中艾滋病毒耐药性(HIVDR)流行情况的信息有限。我们实施了一项横断面研究,以估计马拉维最近感染艾滋病毒的孕妇中艾滋病毒传染率。方法:HIVDR研究嵌套在常规产前诊所(ANC)哨点监测调查。用限制性抗原抗体测定法和HIV病毒载量测定法检测干血斑样本是否最近感染。使用Sanger测序对HIV-1蛋白酶和逆转录酶进行测序。药物敏感性预测采用Stanford HIVdb算法(版本8.9)。在Stata 15.1中进行加权分析。结果:在参加ANC调查的21,642名孕妇中,8.4%(1826/21,642)检测出HIV阳性。其中5.0%(92/1826)近期感染HIV, 90.2%(83/92)进行PCR检测。扩增和测序成功率为57.8%(48/83)。任何HIVDR的患病率为14.6% (5/45)(95% CI: 4.7-36.8%),所有这些都表明HIVDR与非核苷类逆转录酶抑制剂(NNRTIs)有关。核苷类逆转录酶抑制剂的HIVDR为7.9% (2/45)(95% CI: 1.4-34.6%)。目前在马拉维未观察到对蛋白酶抑制剂的耐药性。结论:尽管假定的TDR病例数量较少,但我们的研究表明,对NNRTIs的耐药性很高,高于10%的方案改变目标。需要进一步调查,以确定最近感染艾滋病毒的妇女中假定的热带病耐药的确切程度。这些发现支持对开始或正在接受抗逆转录病毒治疗的患者过渡到以整合酶抑制剂为基础的一线方案。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Resistance levels to non-nucleoside reverse transcriptase inhibitors among pregnant women with recent HIV infection in Malawi.

Resistance levels to non-nucleoside reverse transcriptase inhibitors among pregnant women with recent HIV infection in Malawi.

Resistance levels to non-nucleoside reverse transcriptase inhibitors among pregnant women with recent HIV infection in Malawi.

Background: Information on HIV drug resistance (HIVDR) prevalence in people newly diagnosed with HIV is limited. We implemented a cross-sectional study to estimate HIVDR prevalence among pregnant women recently infected with HIV in Malawi.

Methods: The HIVDR study was nested within a routine antenatal clinic (ANC) sentinel surveillance survey. Dried blood spot samples were tested for recent infection using a limiting antigen antibody assay together with HIV viral load testing. HIV-1 protease and reverse transcriptase were sequenced using Sanger sequencing. Drug susceptibility was predicted using Stanford HIVdb algorithm (version 8.9). Weighted analysis was performed in Stata 15.1.

Results: Of the 21,642 pregnant women enrolled in the ANC survey, 8.4% (1826/21,642) tested HIV positive. Of these, 5.0% (92/1826) had recent HIV infection, and 90.2% (83/92) were tested by PCR. The amplification and sequencing success rate was 57.8% (48/83). The prevalence of any HIVDR was 14.6% (5/45) (95% CI: 4.7-36.8%), all of which indicated HIVDR to nonnucleoside reverse transcriptase inhibitors (NNRTIs). HIVDR to nucleoside reverse transcriptase inhibitors was 7.9% (2/45) (95% CI: 1.4-34.6%). Resistance to protease inhibitors currently in use in Malawi was not observed.

Conclusions: Despite the low number of cases with presumed TDR, our study hints that resistance to NNRTIs was high, above the 10% target for regimen change. Further investigation is needed to establish the exact magnitude of presumed TDR among women recently infected with HIV. These findings support the transition to an integrase inhibitor-based first-line regimen for patients initiating or on ART.

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来源期刊
Antiviral Therapy
Antiviral Therapy 医学-病毒学
CiteScore
2.60
自引率
8.30%
发文量
35
审稿时长
4-8 weeks
期刊介绍: Antiviral Therapy (an official publication of the International Society of Antiviral Research) is an international, peer-reviewed journal devoted to publishing articles on the clinical development and use of antiviral agents and vaccines, and the treatment of all viral diseases. Antiviral Therapy is one of the leading journals in virology and infectious diseases. The journal is comprehensive, and publishes articles concerning all clinical aspects of antiviral therapy. It features editorials, original research papers, specially commissioned review articles, letters and book reviews. The journal is aimed at physicians and specialists interested in clinical and basic research.
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