ArticleAIDS (London, England)2010
Postpartum antiretroviral drug resistance in HIV-1-infected women receiving pregnancy-limited antiretroviral therapy.
Article in AIDS (London, England), 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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Who cites it
11 citing papers in PubMed, 32 citations in OpenAlex.
- Combination antiretroviral treatment for women previously treated only in pregnancy: week 24 results of AIDS clinical trials group protocol a5227.Journal of acquired immune deficiency syndromes (1999) · 2014Trial
- No clinically significant drug-resistance mutations in HIV-1 subtype C-infected women after discontinuation of NRTI-based or PI-based HAART for PMTCT in Botswana.Journal of acquired immune deficiency syndromes (1999) · 2013Trial
- Importance of early identification of PrEP breakthrough infections in a generalized HIV epidemic: a case report from a PrEP demonstration project in South Africa.BMC infectious diseases · 2020Article
- Current Status of Point-of-Care Testing for Human Immunodeficiency Virus Drug Resistance.The Journal of infectious diseases · 2017Review
- PMTCT Option B+ Does Not Increase Preterm Birth Risk and May Prevent Extreme Prematurity: A Retrospective Cohort Study in Malawi.Journal of acquired immune deficiency syndromes (1999) · 2017Article
- Impact of antiretroviral drugs in pregnant women and their children in Africa: HIV resistance and treatment outcomes.The Journal of infectious diseases · 2013Review
- Using two on-going HIV studies to obtain clinical data from before, during and after pregnancy for HIV-positive women.BMC medical research methodology · 2012Article
- Selection of HIV resistance associated with antiretroviral therapy initiated due to pregnancy and suspended postpartum.Journal of acquired immune deficiency syndromes (1999) · 2011Article
- Complex decisions in managing HIV infection during pregnancy.Current HIV/AIDS reports · 2011Review
- Emergence and persistence of minor drug-resistant HIV-1 variants in Ugandan women after nevirapine single-dose prophylaxis.PloS one · 2011Article
- In Vivo validation of a bioinformatics based tool to identify reduced replication capacity in HIV-1.The open medical informatics journal · 2010Article
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Authors and funding
5 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundPregnancy-limited antiretroviral therapy (PLAT) drastically reduces HIV-1 transmission to the newborn, but may select for antiretroviral drug resistance mutations in mothers.
methodsWe evaluated antiretroviral-naive, HIV-1-infected pregnant women who received PLAT between 1998 and 2005, and had 2-month or 6-month postpartum plasma samples available with HIV-1 RNA levels more than 500 copies/ml. Postpartum drug resistance mutation rates were assessed blindly using population sequencing and allele-specific PCR (ASPCR) of the M184V, K103N and D30N mutations. Factors associated with selection of drug resistance mutations were investigated.
resultsOne hundred and forty-six women were included. All women received zidovudine and lamivudine during pregnancy; 76% also received nelfinavir and 8.2% nevirapine. Resistance data were available from 114 women (78%). Postpartum rates of single-class, dual-class, and triple-class resistance were, respectively, 43, 6.1 and 0% (63.2, 10.5 and 1.7% by ASPCR). In women receiving dual or triple PLAT, respectively, postpartum M184V/I rates were 65% (95% by ASPCR) and 28.7% (51.6% by ASPCR), respectively (P < 0.01). Postpartum nonnucleoside reverse transcriptase inhibitor (NNRTI) resistance rates among women receiving nevirapine were 25% for K103N (37.5% by ASPCR) and 12.5% for Y188C. Protease inhibitor resistance rates in women receiving nelfinavir were 1.1% for D30N (1.1% by ASPCR) and 1.1% for L90M. Dual versus triple PLAT and prolonged zidovudine exposure were associated with selection of M184V. Nevirapine use and length of zidovudine and lamivudine exposure were associated with selection of K103N.
conclusionPLAT is associated with frequent selection of resistance to drugs with low-genetic barrier. Triple-drug PLAT decreases the odds for M184V selection. Routine postpartum genotypic resistance testing may be useful to guide future treatment decisions in mothers.
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