Nevirapine (NVP) resistance in women with HIV-1 subtype C, compared with subtypes A and D, after the administration of single-dose NVP.
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.
Eshleman
Susan H
SH
Department of Pathology, Johns Hopkins Medical Institutions, Baltimore, Maryland 21205, USA. seshlem@jhmi.edu
Hoover
Donald R
DR
Chen
Shu
S
Hudelson
Sarah E
SE
Guay
Laura A
LA
Mwatha
Anthony
A
Fiscus
Susan A
SA
Mmiro
Francis
F
Musoke
Philippa
P
Jackson
J Brooks
JB
Kumwenda
Newton
N
Taha
Taha
T
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
D019380:Anti-HIV Agents; D014764:Viral Proteins; D019829:Nevirapine