Effect of perinatal short-course zidovudine on the clinical and virological manifestations of HIV-1 subtype E infection in infants

• Published in: Journal of clinical virology 2002-07, Vol.25 (1), p.47-56
• Main Authors: Sutthent, Ruengpung, Chokephaibulkit, Kulkanya, Piyasujabul, Daorung, Vanprapa, Nirun, Roogpisuthipong, Anuwat, Chaisilwatana, Pongsakdi
• Format: Article
• Language: English
• Subjects: Anti-HIV Agents - therapeutic use; Antibiotics. Antiinfectious agents. Antiparasitic agents; Antiviral agents; Base Sequence; Biological and medical sciences; Cells, Cultured; Cohort Studies; DNA, Viral - blood; Female; Genome, Viral; HIV Infections - drug therapy; HIV Infections - physiopathology; HIV Infections - transmission; HIV Infections - virology; HIV Reverse Transcriptase - genetics; HIV-1; HIV-1 - classification; HIV-1 - drug effects; HIV-1 - genetics; Human viral diseases; Humans; Infant, Newborn; Infectious Disease Transmission, Vertical - prevention & control; Infectious diseases; Medical sciences; Molecular Sequence Data; Perinatal Care; Perinatal transmission; Pharmacology. Drug treatments; Phenotype; Phylogeny; Proviruses - genetics; Reverse Transcriptase Inhibitors - therapeutic use; RNA, Viral - blood; Sequence Analysis, DNA; Subtype E; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; ZDV Short course prophylaxis; Zidovudine - therapeutic use
• ISSN: 1386-6532; 1873-5967
• DOI: 10.1016/S1386-6532(01)00258-X

Background: The perinatal short-course zidovudine (ZDV) chemoprophylaxis that can reduce HIV-1 vertical transmission by 51% has been widely practiced in developing countries such as Thailand because of its simpler and less cost. Objectives: To investigate the effects of short-course regimen of oral ZDV for prophylaxis of HIV-1 subtype E vertical transmission among ‘break-through’ HIV-1 infected infants. Study design: The study analyzed clinical and virological outcomes of 80 infants, whose mothers received ZDV prophylaxis starting at 36 weeks gestation (group Z) and 37 infants whose mothers never received anti-retroviral drugs (group C), at the ages of 1–2, 4–6, and 12 months. Results: Of the 12 HIV-1 infected infants, 5/7 (71.4%) from group Z and 1/5 (20%) from group C progressed to a symptomatic clinical stage by the age 4–6 months. The intersample nucleotide distance of HIV-1 pol reverse transcriptase (RT) sequences of isolates collected at age of 1–2 months from group Z was significantly higher than that from group C (3.34 and 2.92%, P=0.02). All twelve virus isolates from infected infants were non syncytium inducing (NSI) and macrophage tropic strains; and 5/6 (83.3%) viruses from symptomatic infants were also T-tropic viruses. The symptomatic infants also had significantly higher HIV-1 nucleic acid quantitation than asymptomatic infants. Conclusion: Our results preliminary suggested that infected infants who were perinatally exposed to ZDV may have a more rapid early disease progression with unfavorable viral manifestations than those without exposure to antiretroviral drug.