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【medical-news】耐药HIV能够快速隐匿于婴儿细胞内
5/1/2007
耐药HIV能够快速隐匿于婴儿细胞内
Source: Infectious Diseases Society of America
来源：美国感染病学会
New evidence shows that drug-resistant virus passed from mother-to-child can quickly establish itself in infants’ CD4+ T cells where it can hide for years, likely limiting their options for future treatment. The study is published in the May 15 issue of The Journal of Infectious Diseases, now available online.
新证据表明：母婴传播的耐药HIV能够快速定植于婴儿的CD4阳性T细胞内并能够隐匿多年，这很可能会限制以后的抗病毒治疗的选择。该研究发表在5月15日感染病杂志上，现在网上已经可以获得该文章。
Mother-to-child transmission of HIV is an important factor in the AIDS pandemic, although important strides have been made in limiting transmission with antiviral drug therapies before, during, and following birth. In the last few decades the rate of mother-to-child transmission of HIV in the United States has been reduced from 25 percent to its current rate of less than 2 percent. However, the transmission of drug-resistant strains of HIV from mother to child is still a problem, and much is unknown concerning how such transmission affects the responses of infants to various drug treatments.
尽管在产前、产中和产后应用抗逆转录病毒药物治疗能够限制母婴传播，但是HIV母婴传播仍然是艾滋病大流行的重要的因素之一。近几十年来，美国HIV母婴传播的几率已经由25%下降到不足2%，但是耐药HIV的母婴传播仍然是个问题，目前尚不能确定这种传播对婴儿各种药物治疗的影响。
The study, conducted by Deborah Persaud, MD, of Johns Hopkins University School of Medicine and colleagues working throughout the United States, analyzed HIV-infected infants less than six months of age enrolled in a large, multi-center clinical trial covering 10 states.
由约翰霍普金斯大学医学院的Deborah Persaud医学博士和他工作在全美国同事共同开展了下面的研究：在美国10个州进行大规模、多中心的临床试验，分析6个月以下的HIV感染婴儿。
Their results showed that five of 21 HIV-positive infants were infected with drug-resistant HIV transmitted from their mothers—a surprisingly high figure. Of those five, four were resistant to non-nucleoside reverse transcriptase inhibitors (NNRTIs), a common class of antiretroviral drug used to treat HIV infection and to prevent mother-to-child transmission. All had uncommon drug-resistance mutations that some resistance tests would miss.
结果显示：21个HIV阳性婴儿中有5个发生了耐药HIV母婴传播，比例惊人的高。在这5个婴儿中，有4个的耐药HIV对非核苷类逆转录酶抑制剂（目前最常用的一类治疗和阻断HIV母婴传播的药物）有耐药性。所有5例均有少见的耐药突变，这些突变一些耐药检测无法检出。
Earlier studies looking at infants treated with antiretrovirals in an unsuccessful attempt to prevent mother-to-child transmission found the virus quickly developed resistance, but levels of resistant virus declined over time to undetectable levels. In the current study, however, researchers found these resistant viruses quickly took up residence in inactive T cells, from where they could later launch an attack that NNRTIs could not stop. The news was not all bad: a different class of antiretroviral drugs, protease inhibitors (PIs), was effective in controlling HIV viral load and NNRTI-resistant virus strains for all infants studied.
早先的针对HIV母婴传播阻断失败的婴儿抗逆转录病毒治疗的研究发现：病毒能够快速产生耐药性，但随着时间的推移，耐药病毒水平下降到无法检出。然而，在当前的研究中，研究者发现这些耐药病毒能够快速在静止状态的T细胞内定植，这些耐药病毒能够在以后从这些地方发动攻击，而非核苷类逆转录酶抑制剂无法阻断其攻击。这并不是彻底的坏消息，另一种抗逆转录病毒药物，蛋白酶抑制剂能够有效控制研究中所有的婴儿的病毒载量和非核苷类逆转录酶抑制剂耐药病毒株。
These findings have important implications when it comes to choosing among available treatments. As Persaud summarized, "The initial transmitted drug-resistant virus will likely never be cleared from that infant with currently available treatments. However, it is important to point out that because PIs are the first-line drugs used to treat HIV infection in infants in the United States, PI-containing treatment was still effective in controlling the NNRTI-resistant virus in the infants in this study. As long as you do not use NNRTI-based treatment in these infants, you avoid applying pressure that allows drug-resistant HIV to flourish."
当面临治疗选择的时候，这些发现有重要的意义。正如Persaud的总结：“最初传播的耐药病毒应用现有的治疗很可能永远都无法从婴儿体内清除，但是由于在美国蛋白酶抑制剂是婴儿HIV感染治疗的一线用药，包含蛋白酶抑制剂的治疗仍然能够有效的控制非核苷类逆转录酶抑制剂耐药病毒，指出这一点是非常重要的。”
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作者:admin@医学,生命科学 2011-06-15 17:11
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