Antiretroviral resistance profile in HIV1 infected pregnant women: a french prospective study in 93 patients.
Int Conf AIDS 2002 Jul 7-12; 14:(abstract no. B10182)
Ciraru-Vigneron N, Mazeron MC, Lefevre V, Colonna R, Chaix ML, Burgard M, Rouzioux MC CHU - Lariboisiere-Saint Louis, Necker - Universities of Paris VII &V, PARIS, France
To prevent materno fetal transmission (MFT) HIV1 infected pregnant women (HIPW) of developed countries received antiretroviral treatment (ART) and MFT rate is 1% to 2% although most ART are still given on a probable effective basis. In HIPW few data are available on HIV1 drug resistance profile, therefore the aim of our study was to assess virus genotypic profile at beginning of pregnancy and at delivery. From 1999 to 2001, 93 HIPW delivering in Paris were unrolled in a prospective study. Viral load was measured by bDNA technology (Bayer). Protease (PR) and reverse transcriptase (RT) genes were sequenced using Trugene HIV1 genotyping system (Visible Genetics). In group A, 63 patients entered the study without ART: 51 naïve (46 African, 5 Caucasian), and 12 African treated only for a previous pregnancy. In group B, 30 patients were or had been on ART (28 African, 2 Caucasian). All patients received third trimester ART. In group A first viral load ranged from 115 to 407000 copies (median 5900); none of the viral exhibited major mutations but all the African samples had at least one minor associated mutation on the PR gene (mostly 36i). At delivery viral load ranged from under 50 to 93000 copies (median 190), therefore 70% of the samples could not be tested. A few major mutations appeared on RT (M184, K103), none on PR. In group B, first viral load ranged from under 50 to 122000 copies (median 1900); only 2 patients had multiple genotypic resistances; in Africans minor mutation were seen on PR gene. At delivery viral load ranged from under 50 to 10755 copies (median 400); a few major mutation appeared on RT. Only 2 patients transmitted. Since some patients have not yet delivered more complete data will be presented. This study is very reassuring: at beginning of pregnancy no major mutation is seen in naïve and seldom in pretreated; after pregnancy ART few major mutation appear on RT, none on PR, however one should consider the polymorphism of PR gene in Africans
Keywords: AEGIS, Viral Load, Prospective Studies, RNA-Directed DNA Polymerase, Mutation, Paris, Pregnant Women, Human, Female, Pregnancy, pathogenicity, genetics
