Document Detail

Analysis of nevirapine resistance in HIV-infected infants who received extended nevirapine or nevirapine/zidovudine prophylaxis.
MedLine Citation:
PMID:  21487249     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: In the Post Exposure Prophylaxis of Infants (PEPI)-Malawi trial, infants received up to 14 weeks of extended nevirapine (NVP) or extended NVP with zidovudine (NVP + ZDV) to prevent postnatal HIV transmission. We examined emergence and persistence of NVP resistance in HIV-infected infants who received these regimens prior to HIV diagnosis.
METHODS: Infant plasma samples collected at 14 weeks of age were tested using the ViroSeq HIV Genotyping System and a sensitive point mutation assay, LigAmp (for K103N and Y181C). Samples collected at 6 and 12 months of age were analyzed using LigAmp.
RESULTS: At 14 weeks of age, NVP resistance was detected in samples from 82 (75.9%) of 108 HIV-infected infants. Although the frequency of NVP resistance detected by ViroSeq was lower in the extended NVP + ZDV arm than in the extended NVP arm, the difference was not statistically significant (38/55 = 69.1% vs. 44/53 = 83.0%, P = 0.12). Similar results were obtained using LigAmp. Using LigAmp, the proportion of infants who still had detectable NVP resistance at 6 and 12 months was similar among infants in the two study arms (at 6 months: 17/20 = 85.0% for extended NVP vs. 21/26 = 80.8% for extended NVP + ZDV, P = 1.00; at 12 months: 9/16 = 56.3% for extended NVP vs.10/13 = 76.9% for extended NVP + ZDV, P = 0.43).
CONCLUSION: Infants exposed to extended NVP or extended NVP + ZDV had high rates of NVP resistance at 14 weeks of age, and resistant variants frequently persisted for 6-12 months. Frequency and persistence of NVP resistance did not differ significantly among infants who received extended NVP only vs. extended NVP + ZDV prophylaxis.
Jessica Fogel; Donald R Hoover; Jin Sun; Lynne M Mofenson; Mary G Fowler; Allan W Taylor; Newton Kumwenda; Taha E Taha; Susan H Eshleman
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Publication Detail:
Type:  Journal Article; Research Support, N.I.H., Extramural; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  AIDS (London, England)     Volume:  25     ISSN:  1473-5571     ISO Abbreviation:  AIDS     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-04-13     Completed Date:  2011-07-25     Revised Date:  2013-06-30    
Medline Journal Info:
Nlm Unique ID:  8710219     Medline TA:  AIDS     Country:  England    
Other Details:
Languages:  eng     Pagination:  911-7     Citation Subset:  IM; X    
Department of Pathology, Johns Hopkins University School of Medicine, 720 Rutland Avenue, Baltimore, MD 21205, USA.
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MeSH Terms
Anti-HIV Agents / administration & dosage*
Drug Resistance, Viral / drug effects,  genetics
HIV Infections / drug therapy*,  immunology,  transmission
HIV-1 / drug effects*,  genetics
Infectious Disease Transmission, Vertical
Nevirapine / administration & dosage*
Post-Exposure Prophylaxis
Viral Load
Zidovudine / administration & dosage*
Grant Support
R01 AI087139/AI/NIAID NIH HHS; R03 HD061299/HD/NICHD NIH HHS; U01 AI068613/AI/NIAID NIH HHS; U01 AI068613-05/AI/NIAID NIH HHS; U01 AI068633/AI/NIAID NIH HHS; U50/CCU022061//PHS HHS
Reg. No./Substance:
0/Anti-HIV Agents; 129618-40-2/Nevirapine; 30516-87-1/Zidovudine
Comment In:
AIDS. 2011 Apr 24;25(7):997-9   [PMID:  21487253 ]

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