title: Maternal viral genotypic zidovudine resistance and infrequent failure of zidovudine therapy to prevent perinatal transmission of human immunodeficiency virus type 1 in pediatric AIDS Clinical Trials Group Protocol 076.
abstract: Maternal samples were assessed from 96 women enrolled in Pediatric AIDS Clinical Trials Group protocol 076 to determine the prevalence of human immunodeficiency virus type 1 (HIV-1) genotypic zidovudine resistance at entry, if zidovudine resistance developed on study, and the role of zidovudine resistance in vertical transmission of HIV-1 despite zidovudine therapy. Low and high levels of genotypic resistance were assessed by differential hybridization, oligoligation, or direct sequencing of plasma HIV-1 RNA for codons K70R and T215Y/F. None of the women had high-level genotypic resistance to zidovudine at study entry or delivery. For low-level zidovudine resistance, the 95% confidence intervals were 0.3%-6.8% for baseline prevalence and 0.3%-14% for delivery incidence. Low-level zidovudine resistance, adjusted for plasma viral RNA level at delivery, was not strongly associated with an increase in vertical transmission risk (odds ratio, 4.8; 95% confidence interval, 0.2-131; P = .35).
authors.affiliation: Chiron Corporation, Emeryville, California, USA.
authors.forename: P S
authors.initials: PS
authors.lastname: Eastman
authors.forename: D E
authors.initials: DE
authors.lastname: Shapiro
authors.forename: R W
authors.initials: RW
authors.lastname: Coombs
authors.forename: L M
authors.initials: LM
authors.lastname: Frenkel
authors.forename: G D
authors.initials: GD
authors.lastname: McSherry
authors.forename: P
authors.initials: P
authors.lastname: Britto
authors.forename: S A
authors.initials: SA
authors.lastname: Herman
authors.forename: R S
authors.initials: RS
authors.lastname: Sperling
mesh_terms: D002985:Clinical Protocols; D004198:Disease Susceptibility; D004352:Drug Resistance, Microbial / Q000235:genetics; D005260:Female; D005838:Genotype; D015658:HIV Infections / Q000517:prevention & control* / Q000635:transmission / Q000821:virology; D015497:HIV-1 / Q000235:genetics*; D006801:Humans; D007231:Infant, Newborn; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control*; D009154:Mutation; D011247:Pregnancy; D017211:Treatment Failure; D015215:Zidovudine / Q000627:therapeutic use*
chemical_list: D015215:Zidovudine