Abstract
We compared nevirapine (NVP) resistance (NVPR) mutations in maternal plasma 7 days vs. 6-8 weeks after single-dose NVP prophylaxis. In the HIVNET 012 trial, Ugandan women received a single dose of NVP in labor for prevention of HIV-1 mother-to-child transmission. NVPR mutations were detected in 70 (25%) of 279 women 6-8 weeks after NVP. Samples collected 7 days after NVP were analyzed from a subset of those 279 women. Genotyping was performed with the ViroSeq HIV-1 Genotyping System. NVPR was analyzed using paired samples from 7 days and 6-8 weeks after NVP. Sixty-five women had genotyping results obtained for samples collected at both 7 days and 6-8 weeks post-NVP. Twenty-one (32%) of those women had NVPR mutations detected in one or both samples. This included three women with NVPR at 7 days only, seven with NVPR at 6-8 weeks only, and 11 with NVPR at both time points. Eight women had >1 NVPR mutation detected 7 days after NVP. Y181C was the most common NVPR mutation detected at 7 days, whereas K103N was the most common NVPR mutation detected at 6-8 weeks. We conclude that NVPR may be detected in women as early as 7 days after single-dose NVP. Complex patterns of NVPR are detected in some women. The Y181C NVPR mutation often fades from detection by 6-8 weeks. In contrast, the K103N mutation emerges more slowly, but often remains detectable 6-8 weeks after NVP.
Publication types
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Clinical Trial
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Comparative Study
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Randomized Controlled Trial
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Research Support, Non-U.S. Gov't
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Research Support, U.S. Gov't, P.H.S.
MeSH terms
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Amino Acid Substitution
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Anti-HIV Agents / administration & dosage
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Anti-HIV Agents / pharmacology
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Anti-HIV Agents / therapeutic use*
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Drug Resistance, Viral / genetics*
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Female
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Genotype
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HIV Infections / drug therapy*
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HIV Infections / prevention & control
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HIV Infections / transmission
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HIV Infections / virology*
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HIV Protease / genetics
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HIV Reverse Transcriptase / genetics
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HIV-1 / drug effects
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HIV-1 / genetics*
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HIV-1 / isolation & purification
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Humans
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Infectious Disease Transmission, Vertical / prevention & control
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Molecular Sequence Data
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Mutation
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Nevirapine / administration & dosage
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Nevirapine / pharmacology
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Nevirapine / therapeutic use*
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Selection, Genetic
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Sequence Analysis, DNA
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Time Factors
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Uganda
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Viral Proteins / genetics
Substances
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Anti-HIV Agents
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Viral Proteins
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Nevirapine
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HIV Reverse Transcriptase
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HIV Protease
Associated data
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