2011
DOI: 10.3851/imp1698
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Minor Drug-Resistant HIV Type-1 Variants in Breast Milk and Plasma of HIV Type-1-Infected Ugandan Women after Nevirapine Single-Dose Prophylaxis

Abstract: Background: Nevirapine single-dose (NVP-SD) reduces mother-to-child transmission of HIV type-1 (HIV-1), but frequently induces resistance mutations in the HIV-1 genome. Little is known about drugresistant HIV-1 variants in the breast milk of women who have taken NVP-SD.

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Cited by 6 publications
(5 citation statements)
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“…The findings of this study underscore the risks of drug-resistant HIV-1 associated with sdNVP to both the mother and to her child for the duration of breastfeeding, and the results suggest a benefit of ZDV use. First, NVP resistance mutations were detected in most mothers during the early months postpartum when most infants breastfeed, as previously reported [4,5]. Second, NVP resistance was usually detectable through the last time point tested, supporting the prolonged persistence of NVP resistance mutants in maternal milk [6].…”
Section: Discussionsupporting
confidence: 76%
“…The findings of this study underscore the risks of drug-resistant HIV-1 associated with sdNVP to both the mother and to her child for the duration of breastfeeding, and the results suggest a benefit of ZDV use. First, NVP resistance mutations were detected in most mothers during the early months postpartum when most infants breastfeed, as previously reported [4,5]. Second, NVP resistance was usually detectable through the last time point tested, supporting the prolonged persistence of NVP resistance mutants in maternal milk [6].…”
Section: Discussionsupporting
confidence: 76%
“…NVP-SD is widely used for prevention of mother-to-child transmission of HIV-1 in resource-constrained settings but it frequently induces resistance mutations in the HIV-1 genome [2] – [7] . Here, we measured NVP-resistant HIV-1 at proportions as low as 1% in 29 Ugandan women from 1 week up to 18 months after NVP-SD prophylaxis.…”
Section: Discussionmentioning
confidence: 99%
“…The major drawback, however, of using the Non-nucleoside Reverse Transcriptase Inhibitor (NNRTI) NVP is the frequent emergence of NVP-resistant HIV-1 variants even after single-dose intake as a result of NVP's low genetic barrier [2] - [7] . There is evidence that treatment failure of a subsequent NVP- or other NNRTI-based antiretroviral therapy (ART) is more likely for women with prior NVP exposure which has been connected to drug resistance [8] - [10] .…”
Section: Introductionmentioning
confidence: 99%
“…However, the use of sdNVP has also been associated with the emergence of nonnucleoside reverse transcriptase inhibitor (NNRTI) resistance, detected by standard genotyping, in a significant subset of women and infants exposed to sdNVP [15][16][17]. Even more concerning was the finding that with the use of more sensitive assays, the majority of women and children who had received sdNVP harbored NNRTI resistance mutations, often at frequencies below the detection of standard genotyping [18][19][20][21][22][23][24][25]. The proportion of NNRTIresistant minority variants decays over time, but they could still be detected in both women and infants a year or more after sdNVP exposure [23][24][25][26][27].…”
Section: Nonnucleoside Reverse Transcriptase Inhibitor Resistance Aftmentioning
confidence: 99%