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首页> 外文期刊>AIDS Research and Human Retroviruses >Short communication: Different mutation patterns in subtype CRF06_cpx after mother-to-child transmission.
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Short communication: Different mutation patterns in subtype CRF06_cpx after mother-to-child transmission.

机译：简短的交流：母婴传播后，CRF06_cpx亚型的突变方式不同。

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Abstract Development of drug resistance mutation patterns (DRMP) in HIV after treatment failure depends on the drugs used in the failing regimen. However, selected patterns may not be unique; there is evidence that selection of DRMP for nelfinavir is dependent on subtype and/or background polymorphisms. Here we describe the selection of DRMP in a mother and son infected with subtype CRF06_cpx by mother-to-child transmission. Four years after delivery the mother received stavudine/lamivudineelfinavir as first-line therapy. Genotypic resistance tests (GRT) during follow-up showed selection of M184V/L283I in reverse transcriptase (RT) and H63Q/A71V/L90M in protease (PR). The child started treatment 8 months after birth with stavudine/didanosineelfinavir followed by an intensification period with efavirenz. Due to toxicity, efavirenz was removed from the regimen again. GRT during follow-up showed selection of L74V/K103N/M184V/M230L in RT and M46I/H63Q/N88S in PR. The viral load (VL) of the mother was initially undetectable followed by intermediate replication (1000-21,000 copies/ml), whereas the child had both periods of undetectable VL and low-level replication. Although both patients were infected with the same virus and treated with the same protease inhibitor, different DRMPs were selected. Whether the nucleoside backbone, course of antiretroviral therapy, or different host environment is responsible for this variability must be determined in larger studies.
机译：摘要治疗失败后艾滋病毒中的耐药变异模式（DRMP）的发展取决于失败方案中使用的药物。但是，选定的模式可能不是唯一的。有证据表明奈非那韦对DRMP的选择取决于亚型和/或背景多态性。在这里，我们描述了通过母婴传播感染了CRF06_cpx亚型的母子对DRMP的选择。分娩四年后，母亲接受司他夫定/拉米夫定/纳非那韦作为一线治疗药物。随访期间的基因型抗性测试（GRT）显示，选择了逆转录酶（RT）中的M184V / L283I，选择了蛋白酶（PR）中的H63Q / A71V / L90M。婴儿出生后8个月开始用司他夫定/地达诺辛/奈非那韦开始治疗，随后使用依非韦伦强化治疗。由于毒性，依法韦仑再次从治疗方案中移除。随访期间的GRT显示在RT中选择L74V / K103N / M184V / M230L，在PR中选择M46I / H63Q / N88S。母亲的病毒载量（VL）最初是无法检测到的，随后是中间复制（1000-21,000拷贝/ ml），而孩子的VL和低水平复制都是这两个时期。尽管两名患者均感染了相同的病毒并接受了相同的蛋白酶抑制剂治疗，但仍选择了不同的DRMP。在更大的研究中必须确定是核苷骨架，抗逆转录病毒疗法的疗程还是不同的宿主环境导致这种变异。

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