Document Detail


Drug resistance among HIV-infected pregnant women receiving antiretrovirals for prophylaxis.
MedLine Citation:
PMID:  17197811     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To quantify primary resistance mutations (PRMs) among HIV-1-infected women receiving antiretroviral therapy (ART) for prevention of mother-to-child transmission (MTCT). METHODS: Peripheral blood mononuclear cell samples from HIV-1-infected women enrolled in a prospective cohort study in Argentina, the Bahamas, Brazil, and Mexico (NISDI Perinatal Study) were assayed for PRMs. Eligible women were those enrolled by March 2005 and diagnosed with HIV-1 infection during the current pregnancy, and who received ART for MTCT prophylaxis and were followed for 6-12 weeks postpartum. RESULTS: Of 819 women, 198 met the eligibility criteria. At enrollment, 98% were asymptomatic, 62% had plasma viral load < 1000 copies/ml, 53% had CD4+ cell count > or = 500 cells/microl, and 78% were ART-exposed (mean duration, 8.0 weeks; 95% confidence interval, 7.1-8.9). The most complex ART regimen during pregnancy was usually (81%) a three-drug regimen [two nucleoside reverse transcriptase inhibitors (NRTIs) + one protease inhibitor or two NRTIs + one non-nucleoside reverse transcriptase inhibitor). PRMs were observed in samples from 19 (16%) of 118 women that were amplifiable at one or both time points [11/76 (14%) at enrollment; 14/97 (14%) at 6-12 weeks]. The occurrence of PRMs was not associated with clinical, immunological, or virological disease stage at either time point, whether ART-naive versus exposed at enrollment, or the most complex or number of antiretroviral drug regimens received during pregnancy (P > 0.1). Of 55 women with amplifiable samples at both time points, PRMs were detected in 11 samples (20%). CONCLUSIONS: PRMs occurred among 16.1% of relatively healthy HIV-1-infected mothers from Latin American and Caribbean countries receiving MTCT prophylaxis.
Authors:
Adriana S Duran; Marcelo H Losso; Horacio Salomón; D Robert Harris; Sandra Pampuro; Luis E Soto-Ramirez; Geraldo Duarte; Ricardo S de Souza; Jennifer S Read;
Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  AIDS (London, England)     Volume:  21     ISSN:  0269-9370     ISO Abbreviation:  AIDS     Publication Date:  2007 Jan 
Date Detail:
Created Date:  2007-01-01     Completed Date:  2007-03-29     Revised Date:  2008-11-21    
Medline Journal Info:
Nlm Unique ID:  8710219     Medline TA:  AIDS     Country:  England    
Other Details:
Languages:  eng     Pagination:  199-205     Citation Subset:  IM; X    
Affiliation:
Hosp General de Agudos Jose Maria Ramos Mejia, Buenos Aires, Argentina. aduran@hivramos.org.ar
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MeSH Terms
Descriptor/Qualifier:
Adult
Anti-HIV Agents / therapeutic use*
Antiretroviral Therapy, Highly Active
CD4 Lymphocyte Count
Drug Resistance, Viral / genetics*
Female
HIV Infections / drug therapy,  prevention & control*,  transmission,  virology
HIV-1 / drug effects*,  genetics
Humans
Infectious Disease Transmission, Vertical / prevention & control
Mutation
Pregnancy
Pregnancy Complications, Infectious / drug therapy*
Viral Load
Grant Support
ID/Acronym/Agency:
N01-HD-3-3345/HD/NICHD NIH HHS
Chemical
Reg. No./Substance:
0/Anti-HIV Agents

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