ArticleFrontiers in epidemiology2026
Association between infant post-natal prophylaxis regimens and pretreatment HIV drug resistance in infected infants.
Article in Frontiers in epidemiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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15 authors.
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Abstract
Background: Antiretroviral drugs for preventing mother-to-child transmission (PMTCT) can lead to NRTI resistance in infants who contract HIV despite prophylaxis. We aimed to assess how different post-natal prophylaxis (PNP) strategies; nevirapine (NVP) alone vs zidovudine (ZDV) alone vs dual NVP + ZDV influenced NRTI resistance prevalence. Methods: We analyzed data from nationally representative HIV drug resistance surveys conducted in Kenya where the standard practice was the use of dual NVP + ZDV and Nigeria where the standard practice was the use of NVP PNP. HIV drug resistance was determined using population-based sequencing, and mutations interpreted using the Stanford HIVdb algorithm. Analyses were weighted for multistage sampling and genotyping success rates. Results: Among 557 HIV-infected infants aged <18 months with data on resistance and type of PNP, 29.3% received dual NVP + ZDV PNP, 24.6% received NVP alone, 2.3% received ZDV alone, and 43.8% received no PNP. The prevalence of NRTI resistance was 19.4% (95%CI 15.2-24.3) in Nigeria and 9.6% (95%CI 6.6-13.8) in Kenya ( Conclusions: These findings suggest an association between type of PNP and the development of NRTI resistance in HIV-infected infants. Dual-drug prophylaxis was associated with a low prevalence of NRTI resistance compared to single-drug PNP. Our findings highlight the need for further research on combination prophylactic strategies in minimizing the emergence of drug resistance in this population.
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