Mutações de resistência em gestantes infectadas pelo HIV: uma revisão da literatura
DOI:
https://doi.org/10.15448/1983-652X.2015.3.20327Palavras-chave:
gravidez, HIV, mutação, transmissão vertical de doença infecciosa, resistência a medicamentos.Resumo
Objetivo: O objetivo desta revisão foi buscar na literatura dados sobre a prevalência de mutações de resistência do HIV aos antirretrovirais em gestantes infectadas pelo vírus.
Materiais e Métodos: A busca e seleção de artigos foi realizada nas bases de dados PubMed, Scielo e Biblioteca Virtual em Saúde sem delimitação de data. Os termos utilizados na busca foram: pregnancy, HIV e drug resistance.
Resultados: Foram encontrados 47 estudos relacionados ao assunto, realizados em 26 países, publicados no período de 1998 a 2014. A prevalência de resistência transmitida variou de zero a 18% enquanto a resistência adquirida variou de zero a 50% em amostras coletadas entre 1989 e 2013.
Conclusão: Generalizar os resultados é inviável devido às diferentes características dos estudos. No entanto, o monitoramento contínuo da resistência do HIV aos antirretrovirais em cada localidade é essencial.
Referências
Machado ES, Afonso AO, Nissley DV, Lemey P, Cunha SM, Oliveira RH, et ali. Emergency of primary NNRTI resistance mutations without antiretroviral selective pressure in a HAART-treated child. PLos One 2009; 4(3): e4806.
Cardoso LP, Pereira GA, Viegas AA, Schmaltz LE, Stefani MM. HIV-1 primary and secondary antiretroviral drug resistance and genetic diversity among pregnant women from central Brazil. J Med Virol. 2010 Mar; 82(3):351-7.
Larbalestier N, Mullen J, O’Shea S, Cuttam F, Sabin CA, Chrystie IL, et al. Drug resistance is uncommon in pregnant women with low viral loads taking zidovudine monotherapy to prevent perinatal HIV transmission. AIDS 2003; 17: 2665-2667.
Duran AS, Losso MH, Salomón H, Harris DR, Pampuro S, Soto-Ramirez LE, et al. Drug resistance among HIV-infected pregnant women receiving antiretrovirals for prophylaxis. AIDS 2007; 21 (2): 199-205.
Wind-Rotolo M, Durand C, Cranmer L, Reid A, Martinson N, Doherty M, et al. Identification of nevirapine-resistant HIV-1 in the latent reservoir after single-dose nevirapine to prevent mother-to-child transmission of HIV-1. J Infect Dis (USA) 2009; 199(9): 1301-1309.
Kakehasi FM, Tupinambás U, Cleto S, Aleixo A, Lin E, Melo VH, et al. Persistence of genotypic resistance to nelfinavir among women exposed to prophylactic antiretroviral therapy during pregnancy. AIDS Res Hum Retroviruses. 2007; 23(12): 1515-1520.
Afani A, Ayala M, Meyer A, Cabrera R, Acevedo W. Resistencia primaria a terapia antirretroviral en pacientes con infección por VIH/ SIDA en Chile. Rev Med Chil 2005; 133(3):295-301.
Welles SL, Pitt J, Colgrove R, McIntosh K, Chung PH, Colson A, et al. HIV-1 genotypic zidovudine drug resistance and the risk of maternal—infant transmission in the women and infants transmission study. The Women and Infants Transmission Study Group. AIDS 2000; 14(3):263-71.
Cecchini D, Zapiola I, Giuliano SF, Martinez M, Rodriguez C, Bouzas MB. Transmitted drug resistance in women with intrapartum HIV-1 diagnosis: a pilot epidemiological survey in Buenos Aires, Argentina. J Int AIDS Soc 2014; 17(4 Suppl 3):19704.
Ekpini RA, Nkengasong JN, Sibailly T, Maurice C, Adjé C, Monga BB,et al. Changes in plasma HIV-1-RNA viral load and CD4 cell counts, and lack of zidovudine resistance among pregnant women receiving short-course zidovudine. AIDS 2002; 16(4):625-30.
Church JD, Hudelson SE, Guay LA, Chen S, Hoover DR, Parkin N,et al. HIV type 1 variants with nevirapine resistance mutations are rarely detected in antiretroviral drug-naive African women with subtypes A, C, and D. AIDS Res Hum Retroviruses 2007; 23(6):764-8.
Paredes R, Cheng I, Kuritzkes DR, Tuomala RE. High prevalence of primary lamivudine and nelfinavir resistance in HIV-1-infected pregnant women in the United States, 1998-2004. AIDS 2007; 21(15):2103-6.
Hauser A, Sewangi J, Mbezi P, Dugange F, Lau I, Ziske J, et al. Emergence of Minor Drug-Resistant HIV-1 Variants after Triple Antiretroviral Prophylaxis for Prevention of Vertical HIV-1 Transmission. PLos One 2012; 7:e32055.
Frenkel LM, McKernan J, Dinh PV, Goldman D, Hitti J, Watts DH, et al. HIV type 1 zidovudine (ZDV) resistance in blood and uterine cervical secretions of pregnant women. AIDS Res Hum Retroviruses 2006; 22(9): 870-3.
Eastman PS, Shapiro DE, Coombs RW, Frenkel LM, McSherry GD, Britto P,et al. Maternal viral genotypic zidovudine resistance and infrequent failure of zidovudine therapy to prevent perinatal transmission of human immunodeficiency virus type 1 in pediatric AIDS Clinical Trials Group Protocol 076. J Infect Dis 1998; 177(3):557-64.
Kully C, Yerly S, Erb P, Kind C, Krautheim A, Perrin L, et ali. Codon 215 mutations in human immunodeficiency virus-infected pregnant women. Swiss Collaborative 'HIV and Pregnancy' Study. J Infect Dis 1999; 179(3):705-8.
Palumbo P, Holland B, Dobbs T, Pau CP, Luo CC, Abrams EJ, et al. Perinatal AIDS Collaborative Transmission Study. Antiretroviral resistance mutations among pregnant human immunodeficiency virus type 1-infected women and their newborns in the United States: vertical transmission and clades. J Infect Dis 2001; 184(9):1120-6.
Pillay C, Bredell H, McIntyre J, Gray G, Morris L. HIV-1 subtype C reverse transcriptase sequences from drug-naive pregnant women in South Africa. AIDS Res Hum Retroviruses. 2002; 18(8):605-10.
Juethner SN, Williamson C, Ristig MB, Tebas P, Seyfried W, Aberg JA. Nonnucleoside reverse transcriptase inhibitor resistance among antiretroviral-naive HIV-positive pregnant women. J Acquir Immune Defic Syndr 2003; 32(2):153-6.
Servais J, Lambert C, Karita E, Vanhove D, Fischer A, Baurith T, et al. HIV type 1 pol gene diversity and archived nevirapine resistance mutation in pregnant women in Rwanda. AIDS Res Hum Retroviruses 2004 Mar; 20(3):279-83.
Shah SS, Crane M, Monaghan K, McGowan JP. Genotypic resistance testing in HIV-infected pregnant women in an urban setting. Int J STD AIDS 2004 Jun; 15(6):384-7.
Marechal V, Jauvin V, Selekon B, Leal J, Pelembi P, Fikouma V, et al. Increasing HIV type 1 polymorphic diversity but no resistance to antiretroviral drugs in untreated patients from Central African Republic: a 2005 study. AIDS Res Hum Retroviruses 2006; 22(10):1036-44.
Welles SL, Bauer GR, LaRussa PS, Colgrove RC, Pitt J. Time trends for HIV-1 antiretroviral resistance among antiretroviral-experienced and naive pregnant women in New York City during 1991 to early 2001. J Acquir Immune Defic Syndr 2007; 44(3):329-35.
Abreu CM, Brindeiro PA, Martins AN, Arruda MB, Bule E, Stakteas S,et al. Genotypic and phenotypic characterization of human immunodeficiency virus type 1 isolates circulating in pregnant women from Mozambique. Arch Virol 2008; 153(11):2013-7.
Ndembi N, Lyagoba F, Nanteza B, Kushemererwa G, Serwanga J, Katongole-Mbidde E, et al. Uganda HIV Drug Resistance Working Group. Transmitted antiretroviral drug resistance surveillance among newly HIV type 1-diagnosed women attending an antenatal clinic in Entebbe, Uganda. AIDS Res Hum Retroviruses. 2008; 24(6):889-95.
Soto-Ramirez LE, Rodriguez-Diaz R, Durán AS, Losso MH, Salomón H, Gómez-Carrillo M, et al. NISDI Perinatal Study Group. Antiretroviral resistance among HIV type 1-infected women first exposed to antiretrovirals during pregnancy: plasma versus PBMCs. AIDS Res Hum Retroviruses 2008; 24(6):797-804.
Martinson NA, Morris L, Johnson J, Gray GE, Pillay V, Ledwaba J, et al. Women exposed to single-dose nevirapine in successive pregnancies: effectiveness and nonnucleoside reverse transcriptase inhibitor resistance. AIDS 2009; 23(7):809-16.
Ayouba A, Lien TT, Nouhin J, Vergne L, Aghokeng AF, Ngo-Giang-Huong N,et al. Low prevalence of HIV type 1 drug resistance mutations in untreated, recently infected patients from Burkina Faso, Côte d'Ivoire, Senegal, Thailand, and Vietnam: the ANRS 12134 study. AIDS Res Hum Retroviruses 2009; 25(11):1193-6.
Han J, Wang L, Jiang Y, Zhang Q, Fang L, Yao J, et ali. Resistance mutations in HIV-1 infected pregnant women and their infants receiving antiretrovirals to prevent HIV-1 vertical transmission in China. Int J STD AIDS 2009; 20(4):249-54.
Weinberg A, Forster-Harwood J, McFarland EJ, Pappas J, Davies JK, Kinzie K, et al. Resistance to antiretrovirals in HIV-infected pregnant women. J Clin Virol 2009; 45(1):39-42.
Castelbranco EPAF, Souza ES, Cavalcanti AMS, Martins AN, Alencar LCA, Tanuri A. Frequency of Primary Resistance to Antiretroviral Drugs and Genetic Variability of HIV-1 Among Infected Pregnant Women Recently Diagnosed in Luanda-Angola. AIDS Res Hum Retroviruses 2010; 26:1313-1316.
Gingelmaier A, Eberle J, Kost BP, Bogner JR, Hofmann J, Weissenbacher T, et al. Protease Inhibitor–Based Antiretroviral Prophylaxis during Pregnancy and the Development of Drug Resistance. CID 2010; 50: 890-894.
Rodrigues R, Manenti S, Romao PRT, Ferreira JLP, Batista JPG, Siqueira AFAC, et ali. Young pregnant women living with HIV/ AIDS in Criciuma, Southern Brazil, are infected almost exclusively with HIV type 1 clade C. AIDS Res Hum Retroviruses 2010; 26: 351-357.
Bussmann H, Gomez FH, Roels TH, Wester CW, Bodika SM, Moyo S, et al. Prevalence of Transmitted HIV Drug Resistance in Botswana: Lessons Learned from the HIVDR-Threshold Survey Conducted Among Women Presenting for Routine Antenatal Care as Part of the 2007 National Sentinel Survey. AIDS Res Hum Retroviruses 2011; 27: 365-372.
Pando MA, Gómes-Carrillo M, Vignoles M, Rubio AE, Ramos-Farias MS, Vila M, et al. Incidence of HIV Type 1 Infection, Antiretroviral Drug Resistance, and Molecular Characterization in Newly Diagnosed Individuals in Argentina: A Global Fund Project. AIDS Res Hum Retroviruses 2011; 27:17-23.
Parboosing R, Naidoo A, Gordon , Taylor M, Vella V. Resistance to Antiretroviral Drugs in Newly Diagnosed, Young Treatment-Naïve HIV-Positive Pregnant Women in the Province of KwaZulu-Natal, South Africa. J Med Virol 2011; 83:1508-1513.
Thorat SR, Chatubhuj DN, Hingankar NK, Chandrasekhar V, Koppada R, Datkar SR, et al. Surveillance of Transmitted HIV Type 1 Drug Resistance Among HIV Type 1-Positive Women Attending an Antenatal Clinic in Kakinada, India. Res Hum Retroviruses 2011; 27:1291-1297.
Tshabalala M, Manasa J, Zijenah LS, Rusakaniko S, Kadzirange G, Mucheche M, et al. Surveillance of Transmitted Antiretroviral Drug Resistance among HIV-1 Infected Women Attending Antenatal Clinics in Chitungwiza, Zimbabwe. PLos One 2011; 6:e21241.
Ajoge HO, Gordon ML, Ibrahim S, Shittu OS, Ndung’u T, Olonitola SO. Drug Resistance Pattern of HIV Type 1 Isolates Sampled in 2007 from Therapy-Naive Pregnant Women in North-Central Nigeria. Res Hum Retroviruses 2012; 28:115-118.
Alcântara KC, Lins JB, Albuquerque M, Aires LM, Cardoso LP, Minuzzi AL,et ali. HIV-1 mother-to-child transmission and drug resistance among Brazilian pregnant women with high access to diagnosis and prophylactic measures J Clin Virol. 2012; 54(1):15-20.
Caron M, Lekana-Douki SE, Makuwa M, Obiang-Ndong GP, Biba O, Nkoghé D,et ali. Prevalence, genetic diversity and antiretroviral drugs resistance-associated mutations among untreated HIV-1-infected pregnant women in Gabon, central Africa. BMC Infect Dis 2012; 12:64.
Hunt GM, Ledwaba J, Basson AE, Moyes J, Cohen C, Singh B, et al. Surveillance of transmitted HIV-1 drug resistance in Gauteng and KwaZulu-Natal Provinces, South Africa, 2005-2009. Clin Infect Dis 2012; 54 Suppl 4:S334-8.
Somda A, Sangare L, Soro M, Yameogo S, Bazie B, Bigirimana F, et al. Surveillance of transmitted drug-resistant HIV among young pregnant women in Ouagadougou, Burkina Faso. Clin Infect Dis 2012; 54 Suppl 4:S317-9.
Wadonda-Kabondo N, Banda R, Moyo K, M'bang'ombe M, Chiwaula M, Porter C, et ali. Prevalence of transmitted HIV drug resistance among newly diagnosed antiretroviral therapy-naive pregnant women in Lilongwe and Blantyre, Malawi. Clin Infect Dis 2012; 54 Suppl 4:S324-7.
Bila DC, Young P, Merks H, Vubil AS, Mahomed M, Augusto A, et al. Evolution of primary HIV drug resistance in a subtype C dominated epidemic in Mozambique. PLoS One. 2013; 8(7):e68213
Bonney EY, Addo NA, Ntim NA, Addo-Yobo F, Bondzie P, Aryee KE, et al. Low level of transmitted HIV Drug resistance at two HIV care centres in Ghana: a threshold survey. Ghana Med J 2013; 47(2):82-86.
Pilotto JH, Grinsztejn B, Veloso VG, Velasque LS, Friedman RK, Moreira RI, et al. Moderate prevalence of transmitted drug resistance mutations among antiretroviral-naive HIV-infected pregnant women in Rio de Janeiro, Brazil. AIDS Res Hum Retroviruses 2013; 29(4):681-686.
Vairo F, Nicastri E, Liuzzi G, Chaula Z, Nguhuni B, Bevilacqua N,et al. AMANI Study Group. HIV-1 drug resistance in recently HIV-infected pregnant mother's naïve to antiretroviral therapy in Dodoma urban, Tanzania. BMC Infect Dis 2013; 13:439.
Imade GE, Sagay AS, Chaplin B, Chebu P, Musa J, Okpokwu J, et al. Short communication: Transmitted HIV drug resistance in antiretroviral-naive pregnant women in north central Nigeria. AIDS Res Hum Retroviruses 2014;30(2):127-133
Reis MN, de Alcântara KC, Cardoso LP, Stefani MM. Polymorphisms in the HIV-1 gp41 env gene, natural resistance to enfuvirtide (T-20) and pol resistance among pregnant Brazilian women. J Med Virol 2014;86(1):8-17
Pilotto JH, Grinsztejn B, Veloso V, Couto-Fernandez JC, Rodrigues-Pedro A, Velaso-de-Castro CA, et al. HIV drug resistance after HAART discontinuation among treatment naive women who initiated antiretroviral therapy for the prevention of mother-to-child transmission in Rio de Janeiro, Brazil. Antivir Ther. 2009; 14 (suppl 1): A167 (abstract nº 144).
Westin MR, Biscione FM, Fonseca M, Ordones M, Rodrigues M, Greco DB, et ali. Resistance-associates mutation prevalence according to subtypes B and non-B of HIV type 1 in antiretroviral-experienced patients in Minas Gerais, Brazil. AIDS Res Hum Retroviruses. 2011; 27(9): 981-987.
Delauguerre C, Chaix ML, Blanche S, Warszawski J, Cornet D, Dollfus C, et al. Perinatal acquisition of drug-resistant HIV-1 infection: mechanism and long-term outcome. Retrovirology 2009; 6:85.
Haaland RE, Hawkins PA, Salazar-Gonzales J, Johnson A, Tichacek A, Karita E, et al. Inflammatory Genital Infections Mitigate a Severe Genetic Bottleneck in Heterosexual Transmission of Subtype A and C HIV-1. PLos Pathog 2009; 5(1): e1000274.
Pasquier C, Cayrou C, Blancher A, Tourne-Petheil C, Berrebi A, Tricoire J, et al. Molecular Evidence for Mother-to-Child Transmission of Multiple Variants by Analysis of RNA and DNA Sequences of Human Immunodeficiency Virus Type 1. J Virol 1998; 72(11): 8493-8501.
Kwiek JJ, Russell ES, Dang KK, Burch CL, Mwapasa V, Meshnick SR, et ali. The Molecular Epidemiology of HIV-1 Envelope Diversity During HIV-1 Subtype C Vertical Transmission in Malawian Mother-Infant Pairs. AIDS 2008; 22(7): 863-871.
Warszawski J, Tubiana R, Le Chenadec J, Blanche S, Teglas JP, Dollfus C, et al. Mother-to-child HIV transmission despite antiretroviral therapy in the ANRS French Perinatal Cohort. AIDS 2008; 22:289-299.
Kourtis AP, Bulterys M. Mother-to-child transmission of HIV: pathogenesis, mechanism and pathways. Clin Perinatol 2010; 37:721-737.
Brasil. Ministério da Saúde. Secretaria de Vigilância em Saúde, Programa Nacional de DST e Aids.Protocolo clínico e diretrizes terapêuticas para adultos vivendo com HIV/ aids. Versão preliminar. Brasília: 2013. 75 p
Sax PE, Islam R, Walensky RP, Losina E, Weinstein MC, Goldie SJ, et al. Should Resistance Testing Be Performed for Treatment-Naive HIV-Infected Patients? A Cost-Effectiveness Analysis. Clin Infect Dis 2005; 41(9): 1316-1323.
Tural C, Ruiz L, Holtzer C, Schapiro J, Pompeyo V, Gonzáles J, et al. Clinical utility of HIV-1 genotyping and expert advice: the Havana Trial. AIDS 2002; 16(2): 209-218.
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