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Publication Details
AFRICAN RESEARCH NEXUS
SHINING A SPOTLIGHT ON AFRICAN RESEARCH
medicine
Selection and persistence of viral resistance in HIV-infected children after exposure to single-dose nevirapine
Journal of Acquired Immune Deficiency Syndromes, Volume 44, No. 2, Year 2007
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Description
BACKGROUND: Single-dose nevirapine (sd-NVP) is the mainstay of prevention of mother-to-child transmission programs in developing countries. Exposure to sd-NVP selects for resistance mutations, however. We longitudinally assessed these mutations in HIV-1-infected infants from Soweto and Durban, South Africa. METHODS: We prospectively followed 465 infants who received sd-NVP after enrolling their mothers when pregnant. If HIV infected, their virus was genotyped, using the ViroSeq HIV-1 Genotyping System, to detect resistant mutations. Those with resistance were genotyped at 6 months and then every 6 months out to 18 months if resistance was detected at the previous visit. RESULTS: Of 53 HIV-infected infants, 24 (45.3%) had detectable resistance at their first visit, when the most frequent mutations were Y181C (75%), K103N (25%), and Y188C (12%). Of those whose visit was before 12 weeks of age, 2 of 42 infants shared identical resistance mutations with their mothers. By 18 months of age, 11 of 24 infants with resistance had died and 1 still had the Y181C mutation. CONCLUSIONS: Resistant mutations were selected in half of the infants exposed to sd-NVP, but fewer were detected over time and, unlike the case in their mothers, Y181C dominated initially and persists. Transient resistance mutations may have a negative impact on highly active antiretroviral therapy in infants and children. © 2007 Lippincott Williams & Wilkins, Inc.
Authors & Co-Authors
Martinson, Neil Alexander
United States, Baltimore
Johns Hopkins University
South Africa, Johannesburg
Perinatal Hiv Research Unit
Morris, Lynn
South Africa, Johannesburg
National Institute for Communicable Diseases
Gray, Glenda E.
South Africa, Johannesburg
University of the Witwatersrand
Moodley, Dhayendre
South Africa, Durban
The Nelson R. Mandela Medical School
Pillay, Visva
South Africa, Johannesburg
National Institute for Communicable Diseases
Cohen, Sarah
South Africa, Johannesburg
National Institute for Communicable Diseases
Dhlamini, Puleng
South Africa, Johannesburg
University of the Witwatersrand
Puren, Adrian
South Africa, Johannesburg
National Institute for Communicable Diseases
Bhayroo, Schene
South Africa, Durban
The Nelson R. Mandela Medical School
Steyn, Jan G.
South Africa, Johannesburg
University of the Witwatersrand
McIntyre, James Alasdair
South Africa, Johannesburg
University of the Witwatersrand
Statistics
Citations: 91
Authors: 11
Affiliations: 5
Identifiers
Doi:
10.1097/QAI.0b013e31802b920e
ISSN:
15254135
Research Areas
Cancer
Infectious Diseases
Maternal And Child Health
Study Locations
South Africa