Tolerance and viral resistance after single-dose nevirapine (NVP) and short-course of tenofovir disoproxil fumarate (TDF) and emtricitabine (FTC) to prevent mother-to-child transmission (PMTCT) of HIV-1: the TEmAA ANRS 12109 phase II trial, step 1

Arrivé, Élise; Blanche, Stéphane; Chaix, Marie‐Laure; Nerrienet, Eric; Rouzioux, Christine; McIntyre, James; Gray, Glenda; Coffie, Patrick A.; Sim, Kruy Leang; Ekouévi, Didier K.; Dabis, François

doi:10.1186/1742-4690-5-s1-o20

Cited by 5 publications

(3 citation statements)

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“…A recent meta-analysis found that at 6 to 8 weeks postpartum, nevirapine mutations may occur in 36% (95% confidence interval (CI) 23–51%) of women who receive single-dose nevirapine at labor and in 53% (95% CI 38%–67%) of their infants who become HIV-infected 6. Use of more sensitive assays has demonstrated an even higher proportion of women with resistant variants, which can persist at very low levels in a small proportion of women for up to 5 years 5.…”

Section: Introductionmentioning

confidence: 99%

Addition of 7 Days of Zidovudine Plus Lamivudine to Peripartum Single-Dose Nevirapine Effectively Reduces Nevirapine Resistance Postpartum in HIV-Infected Mothers in Malawi

Farr¹,

Nelson²,

Ng’ombe³

et al. 2010

JAIDS Journal of Acquired Immune Deficiency Syndromes

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Section: Introductionmentioning

confidence: 99%

Addition of 7 Days of Zidovudine Plus Lamivudine to Peripartum Single-Dose Nevirapine Effectively Reduces Nevirapine Resistance Postpartum in HIV-Infected Mothers in Malawi

Farr¹,

Nelson²,

Ng’ombe³

et al. 2010

JAIDS Journal of Acquired Immune Deficiency Syndromes

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“…The addition of single‐dose TDF/FTC to SD‐NVP, as previously discussed, significantly reduced the development of NNRTI resistance, but did not further reduce the rate of HIV‐1 transmission [18]. A similar strategy was studied in the TEmAA French National Agency for AIDS Research (ANRS) 12109 Trial [55,56]. Thirty‐eight HIV‐positive pregnant women received short‐course ZDV, SD‐NVP and two doses of TDF/FTC at the onset of labour, followed by once daily TDF/FTC for 7 days postpartum.…”

Section: Tdf or Tdf/ftc In Pregnancy And For Prevention Of Mtct: Datamentioning

confidence: 99%

“…Tenofovir plasma levels at delivery in maternal and cord blood were comparable to steady‐state plasma levels in adults on TDF‐based HAART. Two infants had detectable virus at 3 days postpartum, suggesting in utero rather than perinatal transmission [55, 56]. No genotypic resistance to NVP, TDF, ZDV or FTC was reported in the mothers or the two infected infants [55].…”

Section: Tdf or Tdf/ftc In Pregnancy And For Prevention Of Mtct: Datamentioning

confidence: 99%

Tenofovir disoproxil fumarate in pregnancy and prevention of mother‐to‐child transmission of HIV‐1: is it time to move on from zidovudine?

et al. 2009

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ObjectivesZidovudine (ZDV) has been the cornerstone of antiretroviral (ARV) therapy for pregnant women infected with HIV-1 in the prevention of mother-to-child transmission (MTCT) and remains the only licensed ARV for use in pregnancy. We explored the current and future roles of tenofovir disoproxil fumarate (TDF) in the prevention of MTCT of HIV-1. MethodsWe reviewed the published literature by conducting database searches of in vitro, animal and clinical studies, reported in journals and at conferences, using the search terms Tenofovir/gs4331/viread, pregnant/pregnancy, lactate, lactation, natal, reproduce/reproduction, placenta/placental, malformation, and teratogenicity/teratogenic. ResultsIn a macaque model, perinatal exposure to very high dose tenofovir resulted in bone toxicity in some offspring. However, perinatal use of TDF, both single dose and as part of highly active antiretroviral therapy in women, has been well tolerated in the short term by mothers and their infants. Further, the addition of single-dose TDF to single-dose nevirapine (SD-NVP) during delivery following maternal ZDV use during pregnancy significantly reduces the frequency of nonnucleoside reverse transcriptase inhibitor (NNRTI) resistance. ConclusionsThe addition of TDF to SD-NVP reduces NNRTI resistance. The role of TDF in this setting and during pregnancy for reducing rates of MTCT requires investigation. While short-term toxicity data are encouraging, long-term follow-up of exposed mothers and infants is required.Keywords: mother-to-child transmission, nevirapine resistance, tenofovir DF, toxicity Accepted 6 February 2009 Introduction For over a decade, zidovudine (ZDV) has been the cornerstone of antiretroviral therapy (ART) for the prevention of mother-to-child transmission (MTCT) of HIV-1 and, remarkably, it remains the only licensed antiretroviral (ARV) for use during pregnancy. Recent guidelines for treatment-naïve HIV-1-infected nonpregnant adults have seen a shift away from ZDV-based highly active antiretroviral therapy (HAART) because of concerns over toxicity [1,2]. Peripartum use of single-dose nevirapine (SD-NVP), the only ARV available for most pregnant women living with HIV-1 world-wide, while effective in reducing MTCT, is associated frequently with the development of nonnucleoside reverse transcriptase inhibitor (NNRTI) resistance mutations in both mothers and their infants [3][4][5][6]. The widespread use of HAART in resourcerich settings has led to significant reductions in MTCT, with the effects of in utero ART exposure in HIV-uninfected children receiving increasing attention and study [7][8][9][10]. With these issues in mind, we explore the current and future roles of tenofovir disoproxil fumarate (TDF) in the prevention of MTCT of HIV-1, reviewing currently available data from in vitro, animal and clinical studies. The potential benefit of ARVs other than ZDV in prevention of MTCT was first demonstrated for nevirapine (NVP) in the HIVNET 012 trial, which demonstrated a 47% reduction in MTCT compared with pe...

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Prevention in Neglected Subpopulations: Prevention of Mother‐to‐Child Transmission of HIV Infection

Mofenson

2010

CLIN INFECT DIS

108

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Worldwide, >1000 children are newly infected with human immunodeficiency virus (HIV) each day; the majority of these children are in sub-Saharan Africa. The primary mode of HIV acquisition is through mother-to-child transmission (MTCT) during pregnancy, childbirth, or breastfeeding. In well-resourced health care systems, like those in the United States, universal HIV testing for pregnant women, provision of antiretroviral therapy (when needed for maternal health) or prophylaxis, elective cesarean delivery, and avoidance of breastfeeding has reduced MTCT of HIV infection to 1%-2%. However, in resource-limited countries, the perinatal epidemic continues generally unabated. Clinical trials have identified simple, less expensive, effective antiretroviral prophylaxis regimens that can be implemented in resource-limited settings. However, implementation has been slow, and postnatal transmission of HIV through breastfeeding remains a significant challenge. This article will review the research on prevention of MTCT of HIV infection in resource-limited countries and the challenges to expansion of the benefits of preventive interventions for MTCT throughout the world.

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Tolerance and viral resistance after single-dose nevirapine (NVP) and short-course of tenofovir disoproxil fumarate (TDF) and emtricitabine (FTC) to prevent mother-to-child transmission (PMTCT) of HIV-1: the TEmAA ANRS 12109 phase II trial, step 1

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Cited by 5 publications

References 1 publication

Addition of 7 Days of Zidovudine Plus Lamivudine to Peripartum Single-Dose Nevirapine Effectively Reduces Nevirapine Resistance Postpartum in HIV-Infected Mothers in Malawi

Addition of 7 Days of Zidovudine Plus Lamivudine to Peripartum Single-Dose Nevirapine Effectively Reduces Nevirapine Resistance Postpartum in HIV-Infected Mothers in Malawi

Tenofovir disoproxil fumarate in pregnancy and prevention of mother‐to‐child transmission of HIV‐1: is it time to move on from zidovudine?

Prevention in Neglected Subpopulations: Prevention of Mother‐to‐Child Transmission of HIV Infection

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