RESUMO
HIV-1 drug resistance may limit the use of antiretrovirals when attempting to reduce the vertical transmission rate. Establishing the prevalence of the HIV-1 mutations associated with antiretroviral resistance in pregnant women will enable clinicians to maximize the chances of preventing vertical transmission. In order to determine the prevalence of HIV-1 resistant strains among antiretroviral-naive pregnant Thai women, the nucleotide sequences of the HIV-1 polymerase (pol) gene were evaluated. The plasma samples were collected from the women during the 34th week of pregnancy: numerous secondary mutations could be found in the reverse transcriptase (RT) and protease gene, while no primary mutations in the pol gene were found. The result also showed that by detecting the delta32bp deletion within the CCR 5 locus, it was evident that none of HIV-1 infected individuals had homozygous or heterozygous delta32bp deletions of the CCR5 gene; moreover, no CCR5 gene mutations were found in any individual.
Assuntos
Adolescente , Adulto , Fármacos Anti-HIV/uso terapêutico , Farmacorresistência Viral/genética , Endopeptidases/genética , Epidemiologia Molecular , Feminino , Deleção de Genes , Genes pol/genética , Infecções por HIV/tratamento farmacológico , Transcriptase Reversa do HIV/genética , HIV-1/genética , Heterozigoto , Homozigoto , Humanos , Transmissão Vertical de Doenças Infecciosas/prevenção & controle , Mutação/genética , Filogenia , Vigilância da População , Gravidez , Complicações Infecciosas na Gravidez/tratamento farmacológico , Prevalência , RNA Viral/genética , Receptores CCR5/genética , Reação em Cadeia da Polimerase Via Transcriptase Reversa , Tailândia/epidemiologiaRESUMO
Four human immunodeficiency virus type 1 (HIV-1) treatment-naïve Thai patients began antiretrovival therapy with a triple drug regimen -zidovudine plus lamivudine plus indinavir; this regimen was modified at week 20 of therapy because of drug toxicity. The virus in all patients was suppressed to lower than 400 copies/ml while they were taking the triple antiretroviral drug regimen. However, suppression was lost after changing the antiretroviral regimen. A comparison of HIV-1 DNA sequences taken from the baseline (day 0) and week 24 showed no significant overgrowth in HIV-1 drug-resistant strains. There was no difference in the protease and reverse transcriptase (RT) mutation profiles. Resistant variants did not emerge, even after sub-therapeutic levels of antiretroviral drugs had been introduced to these patients for 4 weeks. These findings may have clinical implications for long-term treatment strategies.