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A post‐partum single‐dose TDF/FTC tail does not prevent the selection of NNRTI resistance in women receiving pre‐partum ZDV and intrapartum single‐dose nevirapine to prevent mother‐to‐ child HIV‐1 transmission
Author(s) -
Samuel Reshmi,
Paredes Roger,
Parboosing Raveen,
Moodley Pravi,
Singh Lavanya,
Naidoo Anneta,
Gordon Michelle
Publication year - 2015
Publication title -
journal of medical virology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.782
H-Index - 121
eISSN - 1096-9071
pISSN - 0146-6615
DOI - 10.1002/jmv.24220
Subject(s) - nevirapine , medicine , zidovudine , obstetrics , virology , post partum , transmission (telecommunications) , pregnancy , human immunodeficiency virus (hiv) , viral load , viral disease , antiretroviral therapy , biology , genetics , electrical engineering , engineering
Although the rates of vertical transmission of HIV in the developing world have improved to around 3% in countries like South Africa, resistance to antiretrovirals (ARV) used in Prevention of Mother‐to‐Child transmission (pMTCT) strategies may thwart such outcomes and affect the efficacy of future ARV regimens in mothers and children. This study conducted in Durban, South Africa, between 2010 and 2013 found a high rate of nevirapine (NVP) resistance among women receiving Zidovudine (AZT) from 14 weeks gestation, single dose nevirapine (sd NVP) at the onset of labor and a single dose of coformulated Tenofovir/Emtricitabine (TDF/FTC) postpartum. Using Sanger sequencing, high and intermediate levels of nevirapine (NVP) resistance were detected in 15/44 (34%) and in 1/44 (2%) of women tested, respectively. Most subjects selected the K103N mutation (22% (10/45) of all patients and 66% (10/15) of those with high‐level NVP resistance). Such rate of NVP resistance is comparable to studies where only sd NVP was used. In conclusion, a post‐partum single‐dose TDF/FTC tail does not prevent the selection of NNRTI resistance in women receiving pre‐partum ZDV and intrapartum sd NVP to prevent mother‐to‐child HIV‐1 transmission. J. Med. Virol. 87:1662–1667, 2015 . © 2015 The Authors. Journal of Medical Virology published by Wiley Periodicals, Inc.