Emergence of antiretroviral resistance in HIV-positive women receiving combination antiretroviral therapy in pregnancy

Lyons, F; Coughlan, Suzie; Byrne, Christina M; Hopkins, Susan; Hall, William W.; Mulcahy, Fiona

doi:10.1097/00002030-200501030-00007

Cited by 75 publications

(54 citation statements)

References 7 publications

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“…This was in contrast to others who found resistance mutations in 13-24% of women who received ARV exclusively for PMTCT in different areas of the world. 14,15,17 Factors known to contribute to the development of ARV resistance, such as compliance with therapy, bioavailability of the drugs and genetic barriers of the virus to the development of resistance may have differed across studies, thus explaining the divergent results. In our study, 57 of 117 (49%) of pregnant women received NFV, and half of the NFV recipients with therapeutic drug monitoring during pregnancy required dose increases to compensate for low plasma levels of NFV and its active metabolite (Weinberg et al, submitted for publication).…”

Section: Discussionmentioning

confidence: 99%

“…1,2 However, the widespread use of ARV increased the prevalence of HIV drug-resistance, which may affect the efficacy of HAART for prevention of MTCT (PMTCT). [3][4][5][6][7][8][9][10][11] Furthermore, ARV resistance can also arise in mothers who receive HAART for PMTCT [12][13][14][15][16][17] and compromise future ARV responses in women [18][19][20][21] and/or complicate the management of HIV infection in infants born to mothers who failed PMTCT. [22][23][24][25] The guidelines for management of HIV infection in pregnancy in resource-abundant countries recommend resistance testing in all patients.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Resistance to antiretrovirals in HIV-infected pregnant women

Weinberg

Forster-Harwood

McFarland

et al. 2009

Journal of Clinical Virology

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Resistance to antiretrovirals in HIV-infected pregnant women

Weinberg

Forster-Harwood

McFarland

et al. 2009

Journal of Clinical Virology

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“…Currently, China is conducting ARV therapy on a large scale and NVP is one of very important components. Because of cross drug resistance, drug resistance mutation sites for NVP could lead to resistance to other NNRTIs [18]. Careful attention should be paid by clinical personnel to avoid the spread of strains resistant to these drugs in China.…”

Section: Factors Affecting the Therapeutic Effects Of Arv Drugsmentioning

confidence: 99%

Care of HIV-infected patients in China

Cao

2005

Cell Res

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Compared with high infection areas of the world, the total HIV infection rate in China is relatively low. Nonetheless, because of China's vast territory and large population, the potential infection risk must be taken seriously. In the next few years, needle sharing among injection drug users will remain the most common route of transmission for the HIV/ AIDS epidemic in China. Unprotected sex is gradually becoming a major route of transmission. China began to implement HAART in 1999 according to international standards. Prior to 2003, there were only about 150 HIV/AIDS patients were treated with HAART in some clinical trials and about 100 HIV/AIDS patients were treated by private sources. Results of those treatments are the scientific basis for development of the therapeutic strategies in China. In March of 2003, the Chinese government initiated China CARES program. In November of 2003, the Chinese Ministry of Health announced a national policy of free ARV treatment to all HIV+ Chinese citizens who were in poverty and required ARV therapy. There are total of 19,456 HIV/AIDS patients received free ARV drugs to date in 159 regions and 441 towns. Current challenges are how to follow-up and evaluate those patients in the clinical settings. The longer the therapy is postponed, the more side effects and the higher probability of drug resistance are going to occur. It remains unclear, therefore, when HAART regimen should be started in the HIV/AIDS population in China.

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“…El uso de los regímenes de tratamiento antirretroviral (TARV) en mujeres embarazadas es cosiderada una de las estrategias de prevención más importantes para reducir la transmisión de madre a hijo, debido a que la TARV suprime la replicación viral y restablece y preserva las funciones inmunes (Cooper et al, 2002), sin embargo, el uso de drogas antiretrovirales (ARV) puede inducir el desarrollo de resistencia, pudiendo exponer al niño a riesgo de transmisión (Clavel & Hance, 2004) y disminuyendo las opciones de TARV para el binomio madre-hijo (Duran et al, 2007;Hoffmann C. and Rockstroh, 2012;Johnson et al, 2001;Lyons et al, 2005).…”

Section: Introductionunclassified

Resistencia del VIH en mujeres embarazadas de Honduras durante el año 2015

Parham¹,

Murillo²,

Rivera³

2016

Ciencia y Tecnología

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RESUMENEl tratamiento antirretroviral (TARV) en mujeres embarazadas ha contribuido a la prevención de la transmisión del VIH de madre a hijo. Sin embargo, el desarrollo de resistencia del VIH-1 a la TARV es un problema latente y puede reducir la eficacia del tratamiento en las mujeres embarazadas, generar un riesgo de transmisión de madre a hijo e impactar el manejo clínico de las mujeres embarazadas o de los niños que resulten infectados.Este estudio determinó la presencia de resistencia en mujeres embarazadas VIH-1 positivo (recibiendo TARV) de Tegucigalpa y San Pedro Sula durante el año 2015. Un total de 63 participantes fueron analizadas y en 35 de ellas se obtuvo amplificación exitosa del gen pol del VIH-1 para evaluar la presencia de mutaciones asociadas a resistencia.La cuantificación de carga viral y conteo de CD4 fue realizado a todas las participantes. La prevalencia global de resistencia fue del 17 %. Un 62 % de las participantes presentaron carga viral detectable y en el 16 % recuentos celulares ≤200 celulas/ mm3. La prevalencia de resistencia, la viremia y bajos recuentos celulares indican que podría existir un riesgo de transmisión vertical en esta cohorte.Este estudio proporciona datos actuales sobre la prevalencia de la resistencia a la TARV en población femenina embarazada VIH-1 positivo de Honduras y refleja la necesidad de realizar de forma rutinaria y permanente pruebas de resistencia, carga viral y conteo de CD4, con el fin de apoyar en la prevención de la tramision del VIH-1 en el binomio madre-hijo.

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Emergence of antiretroviral resistance in HIV-positive women receiving combination antiretroviral therapy in pregnancy

Abstract: Emergence of genotypic resistance is significant in this cohort of pregnant women. All mutations detected were in those that took nevirapine-containing regimens. The clinical implications of these mutations are unknown.

Cited by 75 publications

References 7 publications

Resistance to antiretrovirals in HIV-infected pregnant women

Resistance to antiretrovirals in HIV-infected pregnant women

Care of HIV-infected patients in China

Resistencia del VIH en mujeres embarazadas de Honduras durante el año 2015

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