Document Detail


In utero HIV infection is associated with an increased risk of nevirapine resistance in ugandan infants who were exposed to perinatal single dose nevirapine.
MedLine Citation:
PMID:  19552593     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Use of single dose nevirapine (sdNVP) to prevent HIV mother-to-child transmission is associated with the emergence of NVP resistance in many infants who are HIV infected despite prophylaxis. We combined results from four clinical trials to analyze predictors of NVP resistance in sdNVP-exposed Ugandan infants. Samples were tested with the ViroSeq HIV Genotyping System and a sensitive point mutation assay (LigAmp, for detection of K103N, Y181C, and G190A). NVP resistance was detected at 6-8 weeks in 36 (45.0%) of 80 infants using ViroSeq and 33 (45.8%) of 72 infants using LigAmp. NVP resistance was more frequent among infants who were infected in utero than among infants who were diagnosed with HIV infection after birth by 6-8 weeks of age. Detection of NVP resistance at 6-8 weeks was not associated with HIV subtype (A vs. D), pre-NVP maternal viral load or CD4 cell count, infant viral load at 6-8 weeks, or infant sex. NVP resistance was still detected in some infants 6-12 months after sdNVP exposure. In this study, in utero HIV infection was the only factor associated with detection of NVP resistance in infants 6-8 weeks after sdNVP exposure.
Authors:
Jessica D Church; Anthony Mwatha; Danstan Bagenda; Saad B Omer; Deborah Donnell; Philippa Musoke; Clemensia Nakabiito; Chineta Eure; Paul Bakaki; Flavia Matovu; Michael C Thigpen; Laura A Guay; Michelle McConnell; Mary Glenn Fowler; J Brooks Jackson; 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 research and human retroviruses     Volume:  25     ISSN:  1931-8405     ISO Abbreviation:  AIDS Res. Hum. Retroviruses     Publication Date:  2009 Jul 
Date Detail:
Created Date:  2009-07-22     Completed Date:  2009-09-22     Revised Date:  2012-03-08    
Medline Journal Info:
Nlm Unique ID:  8709376     Medline TA:  AIDS Res Hum Retroviruses     Country:  United States    
Other Details:
Languages:  eng     Pagination:  673-7     Citation Subset:  IM; X    
Affiliation:
Johns Hopkins University School of Medicine , Baltimore, Maryland 21205, USA.
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MeSH Terms
Descriptor/Qualifier:
Anti-HIV Agents / administration & dosage*
CD4 Lymphocyte Count
Clinical Trials as Topic
Drug Administration Schedule
Drug Resistance, Viral*
Female
HIV / drug effects*,  genetics
HIV Infections / drug therapy*,  immunology,  transmission
Humans
Infant
Infectious Disease Transmission, Vertical
Nevirapine / administration & dosage*
Pregnancy
Pregnancy Complications, Infectious / drug therapy*,  virology
RNA, Viral / analysis,  drug effects,  genetics
Uganda
Viral Load
Grant Support
ID/Acronym/Agency:
AI-045200/AI/NIAID NIH HHS; N01 AI035173/AI/NIAID NIH HHS; N01 AI045200/AI/NIAID NIH HHS; N01-AI-035173/AI/NIAID NIH HHS; N01-AI-035173-417/AI/NIAID NIH HHS; R01 AI034235-06S1/AI/NIAID NIH HHS; R01-AI-034235-04/AI/NIAID NIH HHS; U01 AI038576-07S3/AI/NIAID NIH HHS; U01 AI046745-01/AI/NIAID NIH HHS; U01 AI048054-01/AI/NIAID NIH HHS; U01 AI068613-04/AI/NIAID NIH HHS; U01 AI068632-02/AI/NIAID NIH HHS; U01 AI068632-03/AI/NIAID NIH HHS; U01-AI-038576-07/AI/NIAID NIH HHS; U01-AI-046745/AI/NIAID NIH HHS; U01-AI-048054/AI/NIAID NIH HHS; U01-AI-068613/AI/NIAID NIH HHS; U01-AI-068632/AI/NIAID NIH HHS
Chemical
Reg. No./Substance:
0/Anti-HIV Agents; 0/RNA, Viral; 129618-40-2/Nevirapine
Comments/Corrections

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