Journal article
Analysis of Nevirapine (NVP) Resistance in Ugandan Infants Who Were HIV Infected Despite Receiving Single-Dose (SD) NVP versus SD NVP Plus Daily NVP Up to 6 Weeks of Age to Prevent HIV Vertical Transmission
The Journal of infectious diseases, Vol.198(7), pp.1075-1082
2008
DOI: 10.1086/591503
PMID: 18684096
Abstract
Background. Single-dose nevirapine (SD NVP) at birth plus NVP prophylaxis for the infant up to 6 weeks of age is superior to SD NVPalone for prevention of vertical transmission of human immunodeficiency virus (HIV) through breastfeeding. We analyzed NVP resistance in HIV-infected Ugandan infants who received either SD NVP or extended NVP prophylaxis.
Methods. We tested plasma HIV by using a genotyping assay (ViroSeq; Celera Diagnostics), a phenotypic resistance assay (PhenoSense; Monogram Biosciences), and sensitive point mutation assay (LigAmp, for K103N, Y181C, and G190A).
Results. When infants were 6 weeks old, ViroSeq detected NVP resistance in a higher proportion of infants in the extended NVP arm than in the SD NVP arm (21 of 25 [84%] vs. 12 of 24 [50%]; P = .01). Similar results were obtained with LigAmp and PhenoSense. In both study arms, infants who were HIV infected at birth frequently had NVP resistance detected. In contrast, infants in the extended NVP arm who were HIV infected after birth were more likely to have resistance detected at 6 weeks, compared with infants in the SD NVP arm. The use of extended NVP prophylaxis was also associated with detection of NVP resistance by ViroSeq at 6 months (7 of 7 [100%] infants in the extended NVP arm had resistance detected, compared with 1 of 6 [16.7%] infants in the SD NVP arm; P = .005).
Conclusions. The use of extended NVP prophylaxis was associated with increased selection for and persistence of NVP resistance in HIV-infected Ugandan infants.
Details
- Title: Subtitle
- Analysis of Nevirapine (NVP) Resistance in Ugandan Infants Who Were HIV Infected Despite Receiving Single-Dose (SD) NVP versus SD NVP Plus Daily NVP Up to 6 Weeks of Age to Prevent HIV Vertical Transmission
- Creators
- Jessica D CHURCH - School of Medicine, Johns Hopkins University, Baltimore, Maryland, United StatesSaad B OMER - School of Public Health, Johns Hopkins University, Baltimore, Maryland, United StatesLaura A GUAY - School of Medicine, Johns Hopkins University, Baltimore, Maryland, United StatesWei Huang - Monogram Biosciences, South San Francisco, California, United StatesJessica LIDSTROM - School of Medicine, Johns Hopkins University, Baltimore, Maryland, United StatesPhilippa MUSOKE - Makerere University, UgandaFrancis MMIRO - Makerere University-Johns Hopkins University Research Collaboration, Kampala, UgandaJ. Brooks JACKSON - School of Medicine, Johns Hopkins University, Baltimore, Maryland, United StatesSusan H ESHLEMAN - School of Medicine, Johns Hopkins University, Baltimore, Maryland, United States
- Resource Type
- Journal article
- Publication Details
- The Journal of infectious diseases, Vol.198(7), pp.1075-1082
- Publisher
- University of Chicago Press; Chicago, IL
- DOI
- 10.1086/591503
- PMID
- 18684096
- ISSN
- 0022-1899
- eISSN
- 1537-6613
- Language
- English
- Date published
- 2008
- Academic Unit
- Pathology; VPMA - Administration
- Record Identifier
- 9984047735602771
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