title: Nevirapine (NVP) resistance in women with HIV-1 subtype C, compared with subtypes A and D, after the administration of single-dose NVP.
abstract: OBJECTIVE
  In the Human Immunodeficiency Virus (HIV) Network for Prevention Trials (HIVNET) 012 trial in Uganda, 6-8 weeks after single-dose nevirapine (SD-NVP), NVP resistance mutations were detected at a higher rate in women with HIV-1 subtype D than in women with subtype A. Here, we evaluate the rate of NVP resistance mutations in women with subtype C.
  
  
  METHODS
  NVP resistance mutations were detected using the ViroSeq HIV-1 Genotyping System.
  
  
  RESULTS
  The portion of women with any NVP resistance mutation was higher in those with subtype C (45/65 [69.2%] in the NVP and zidovudine trial, Malawi) than in those in the HIVNET 012 trial with either subtype A (28/144 [19.4%]; P<.0001) or subtype D (35/97 [36.1%]; P<.0001). In a multivariate model, subtype (C vs. A: odds ratio [OR], 8.73 [95% confidence interval {CI}, 4.29-17.76]; C vs. D: OR, 3.38 [95% CI, 1.65-6.93]) and viral load at delivery (OR, 2.35 [95% CI, 1.62-3.40]) independently predicted NVP resistance mutations, but maternal age, parity, and time between SD-NVP and the 6-8-week visit did not.
  
  
  CONCLUSIONS
  The rate of NVP resistance mutations after SD-NVP was significantly higher in women with HIV-1 subtype C than in women with subtype A or D. Studies are needed to assess the clinical significance of this finding.
authors.affiliation: Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, Maryland 21205, USA. seshlem@jhmi.edu
authors.forename: Susan H
authors.initials: SH
authors.lastname: Eshleman
authors.forename: Donald R
authors.initials: DR
authors.lastname: Hoover
authors.forename: Shu
authors.initials: S
authors.lastname: Chen
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Hudelson
authors.forename: Laura A
authors.initials: LA
authors.lastname: Guay
authors.forename: Anthony
authors.initials: A
authors.lastname: Mwatha
authors.forename: Susan A
authors.initials: SA
authors.lastname: Fiscus
authors.forename: Francis
authors.initials: F
authors.lastname: Mmiro
authors.forename: Philippa
authors.initials: P
authors.lastname: Musoke
authors.forename: J Brooks
authors.initials: JB
authors.lastname: Jackson
authors.forename: Newton
authors.initials: N
authors.lastname: Kumwenda
authors.forename: Taha
authors.initials: T
authors.lastname: Taha
mesh_terms: D000328:Adult; D019380:Anti-HIV Agents / Q000008:administration & dosage / Q000494:pharmacology*; D004334:Drug Administration Schedule; D024882:Drug Resistance, Viral; D005260:Female; D005838:Genotype; D015658:HIV Infections / Q000517:prevention & control*; D015497:HIV-1 / Q000145:classification / Q000187:drug effects* / Q000235:genetics; D006801:Humans; D018445:Infectious Disease Transmission, Vertical / Q000517:prevention & control; D019829:Nevirapine / Q000008:administration & dosage / Q000494:pharmacology*; D011247:Pregnancy; D014764:Viral Proteins / Q000235:genetics
chemical_list: D019380:Anti-HIV Agents; D014764:Viral Proteins; D019829:Nevirapine