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首页> 外文期刊>JAIDS: Journal of acquired immune deficiency syndromes >Effectiveness of short-term and long-term zidovudine prophylaxis on detection of HIV-1 subtype E in human placenta and vertical transmission.
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Effectiveness of short-term and long-term zidovudine prophylaxis on detection of HIV-1 subtype E in human placenta and vertical transmission.

机译：短期和长期预防齐多夫定对检测人胎盘和垂直传播HIV-1亚型E的有效性。

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摘要

Antiretroviral treatment with zidovudine (ZDV) from the 14th week until the end of pregnancy has markedly reduced the vertical transmission rate of HIV-1 in Europe and North America. A shorter duration of treatment has reduced this rate in Africa and Southeast Asia to a lesser degree. In Southeast Asia, subtype E is the major subtype rather than subtype B as in Western countries. The goals of this study were to determine the optimal duration of ZDV prophylaxis for subtype E and to confirm its effectiveness at the histologic level. Fifty pregnant women seropositive for HIV-1 subtype E were given ZDV prophylaxis consisting of 300 mg administered twice daily, switching to 300 mg administered every 3 hours from the onset of labor until delivery. Twenty-seven received "short-term" ZDV lasting 14 to 35 days before delivery, whereas the other 23 received "long-term" ZDV lasting 62 to 92 days. The effectiveness of ZDV prophylaxis was assessed by detection of HIV-1 in the placenta using in situ polymerase chainreaction (PCR). All babies in this study were tested up to one year of age. Three were not positive until after one month of age, but one was positive as a neonate. Four neonates were positive for HIV-1 as detected by PCR on peripheral blood, including one in the neonatal period. All cases were from the short-term prophylaxis group. Decidual glandular epithelial cells were the only cell type in the placenta that expressed HIV proviral DNA under ZDV prophylaxis. Sixty-seven percent of placentas in the short-term ZDV group showed more than occasional positive cells compared with 22% in the group receiving long-term ZDV prophylaxis (P < 0.02). This is first study to compare the effectiveness of short-term and long-term ZDV prophylaxis with respect to the presence of HIV in the placenta. Our study shows that longer (at least 60 days) prophylaxis is more effective in reducing HIV expression in the placenta and is associated with reduced transmission to neonates.
机译：从第14周到妊娠结束，使用齐多夫定（ZDV）进行抗逆转录病毒治疗已在欧洲和北美显着降低了HIV-1的垂直传播率。较短的治疗时间在非洲和东南亚将这一比率降低的程度较小。在东南亚，E型是主要的亚型，而不是西方国家中的B型。这项研究的目的是确定对亚型E的ZDV预防的最佳持续时间，并在组织学水平上确认其有效性。对50名HIV-1亚型E血清反应阳性的孕妇进行ZDV预防，包括每天两次300 mg的给药，从分娩开始到分娩后每3小时改为300 mg。二十七名接受“短期” ZDV的人在分娩前持续14至35天，而其他23名接受了“长期” ZDV的人持续62至92天。使用原位聚合酶链反应（PCR）通过检测胎盘中的HIV-1评估了ZDV预防的有效性。本研究中的所有婴儿均接受了不超过一岁的测试。直到一个月大以后，三个人才是阳性的，但新生儿时一个人是阳性的。通过外周血PCR检测发现，有四名新生儿HIV-1阳性，其中一名新生儿。所有病例均来自短期预防组。在ZDV预防下，蜕膜腺上皮细胞是胎盘中唯一表达HIV前病毒DNA的细胞类型。短期ZDV组中67％的胎盘显示出比偶尔的阳性细胞多，而接受长期ZDV预防的组中的胎盘显示为22％（P <0.02）。这是第一个比较短期和长期ZDV预防与胎盘中HIV的有效性的研究。我们的研究表明，更长的时间（至少60天）的预防措施可以更有效地减少胎盘中的HIV表达，并减少对新生儿的传播。

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